Individual
MS. TABATHA L OBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 LAKE ST N, FOREST LAKE, MN 55025-2504
(763) 607-8473
Mailing address
115 LAKE ST N, FOREST LAKE, MN 55025-2504
(763) 607-8473
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/25/2009
Last updated
01/25/2009
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