Provider Demographics
NPI:1568414233
Name:LARSON, ARNOLD DEAN (PT)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:DEAN
Last Name:LARSON
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 1:1130 SCOTT BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240
Mailing Address - Country:US
Mailing Address - Phone:319-354-2429
Mailing Address - Fax:319-354-6100
Practice Address - Street 1:1130 SCOTT BLVD
Practice Address - Street 2:STE 1
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-354-2429
Practice Address - Fax:319-354-6100
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00798225100000X
CA297084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1026826OtherPREFERRED ONE
IA06-65463Medicaid
IA0481747Medicaid
MN47815LAOtherBC/BS OF MINNESOTA
IA59409OtherWELLMARK BC/BS OF IA