Laraway, Mark

Laraway, Mark is an individual health care provider with primary practice located at 430 5Th St N , Breckenridge MN 56520-1426. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Laraway, Mark can be contacted via phone (218) 641-7725.

Contact Information

Primary practice address
430 5Th St N Breckenridge MN 56520-1426
Phone: (218) 641-7725
Fax: (218) 641-6625
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 3626 Nebraska
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 10615 Minnesota

Profile Details

NPI number 1548713357
LBN Legal business name Laraway, Mark
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2016
Last updated Jun 30th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548713357 NPPES
North Dakota MEDICAID 1470616

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