Kelly Larson, PTA
NPI #1528190998 in Williston, North Dakota
Provider Information
- NPI Number
- 1528190998
- Entity Type
- Individual
- Name
- Kelly Larson, PTA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- Mar 12, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1301 15TH AVE W
- City
- Williston
- State
- North Dakota
- ZIP Code
- 58801-3821
- Phone
- (701) 774-7400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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