Lars T Gustafson, MPT

NPI #1023116506 in Brainerd, Minnesota

Provider Information

NPI Number: 1023116506
Entity Type: Individual
Name: Lars T Gustafson, MPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: MPT
Enumeration Date: Sep 20, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 224 N 5TH ST
City: Brainerd
State: Minnesota
ZIP Code: 56401-3348
Phone: (218) 829-4231

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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