Individual
AMANDA JEAN BOELTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24724 616TH ST, MANTORVILLE, MN 55955-7109
(507) 252-1317
Mailing address
24724 616TH ST, MANTORVILLE, MN 55955-7109
(507) 251-1317
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1724576
MN
Other
Enumeration date
08/07/2023
Last updated
08/08/2023
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