Individual
DR. AMANDA GOERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3301 7TH AVE, ANOKA, MN 55303-4516
(651) 431-5000
Mailing address
3200 LABORE RD STE 104, VADNAIS HEIGHTS, MN 55110-5186
(651) 431-2858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53006
MN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
53006
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26153271
—
NM
Enumeration date
05/03/2008
Last updated
08/22/2023
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