Individual
JOSEPH MATHEW FORTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1901 CONNECTICUT AVE S, SARTELL, MN 56377
(320) 259-4100
(320) 257-5523
Mailing address
11224 LAKEVIEW HEIGHTS RD, PINE CITY, MN 55063-5363
(320) 469-2493
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12790
MN
363A00000X
Physician Assistant
4375-23
WI
Other
Enumeration date
06/20/2018
Last updated
06/08/2020
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