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Individual

SANDRA OGATO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
18275 KENRICK AVE, LAKEVILLE, MN 55044-7306
(866) 389-2727
Mailing address
19131 HARAPPA AVE, LAKEVILLE, MN 55044-4776

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12676
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023526506
MN
Enumeration date
01/18/2018
Last updated
10/13/2022
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