Individual
EMILY ROSE BASTYR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
101 MARTIN LUTHER KING DR, MANKATO, MN 56001-6460
(507) 385-6500
(507) 385-6510
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207Q0000X
MN
207Q00000X
Family Medicine Physician
Primary
62472
MN
Other
Enumeration date
04/20/2016
Last updated
04/24/2019
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