Provider Demographics
NPI:1154500916
Name:LOHN, LARRY EDWARD (PT)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:EDWARD
Last Name:LOHN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2182 66TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-9127
Mailing Address - Country:US
Mailing Address - Phone:320-231-1114
Mailing Address - Fax:
Practice Address - Street 1:2182 66TH AVE NE
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-9127
Practice Address - Country:US
Practice Address - Phone:320-231-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist