| Mr Andrew William Larson, PT | |
|
1400 1st St Ne, New Prague, MN 56071-2215 | |
| (952) 758-2535 | |
| Not Available |
| Full Name | Mr Andrew William Larson |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1400 1st St Ne, New Prague, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922109057 | NPI | - | NPPES |
| 14N46LA | Other | MN | MN BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 6759 (Minnesota) | Primary |
| Provider Name | Tria Orthopaedic Center Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1518273085 PECOS PAC ID: 3173570561 Enrollment ID: O20110310000999 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Andrew William Larson, PT 848 Ramsey Ave, Carver, MN 55315-4515 Ph: () - | Mr Andrew William Larson, PT 1400 1st St Ne, New Prague, MN 56071-2215 Ph: (952) 758-2535 |
Luke Jon Tietz, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 504 6th Ave Nw, New Prague, MN 56071 Phone: 952-257-8800 | |
Colleen Ambroz, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 2nd St Ne, New Prague, MN 56071 Phone: 952-758-4431 | |
John Conrad Masberg, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 2nd St Ne, New Prague, MN 56071 Phone: 952-758-4431 | |
Stephanie Nicole Gill, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 2nd St Ne, New Prague, MN 56071 Phone: 952-257-8800 | |
Dr. Peter Paul Ly, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 504 6th Ave Nw, New Prague, MN 56071 Phone: 952-257-8800 | |
Colleen Marie Turner, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 2nd St Ne, New Prague, MN 56071 Phone: 952-257-8997 | |
Heidi Bell, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 301 2nd St Ne, New Prague, MN 56071 Phone: 952-257-8800 |