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General NPI Number Information
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NPI Number | 1184576266
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Entity Type | Individual
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Provider Name | DAWN CARLSON
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Gender | Female
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 901 SW 22ND AVE
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City | GRAND RAPIDS
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State | MN
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Zip | 55744-3067
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Country | US
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Telephone | 218-259-8380
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Fax |
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Provider Business Mailing Address
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Address Line | 19184 ASHLEY LN
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City | GRAND RAPIDS
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State | MN
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Zip | 55744-5795
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Country | US
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Telephone | 218-259-8380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 6379
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License Number State | MN
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