IndividualActive
Andrew Larson, PT
NPI 1558430488 · Physical Therapist · Roscoe, IL
Provider details
- NPI number
- 1558430488
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4675 Bluestem Rd
Roscoe, IL 61073-7788
Phone: (815) 623-9930
Fax: (815) 623-9931
Approximate (ZIP-level) locationGet directions
Mailing address
2905 Ware Rd
Rockford, IL 61114-6592
Registry dates
- Enumerated
- 2006-11-07
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.