Individual
AGATHA J OTTEM LILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1750 47TH AVE S, GRAND FORKS, ND 58201-7595
(701) 757-8700
(701) 234-1147
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0689
ND
363A00000X
Physician Assistant
12712
MN
Other
Enumeration date
06/28/2017
Last updated
06/22/2026
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