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Individual

MICHELLE LHOTKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3900 PARK NICOLLET BLVD, SAINT LOUIS PARK, MN 55416-2503
(952) 993-3150
Mailing address
8170 33RD AVE SOUTH, 21110Q, MINNEAPOLIS, MN 55430-1309

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01107
WV
363A00000X
Physician Assistant
Primary
11609
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001807776
BLUE CROSS BLUE SHIELD
WV
01
1069730
WORKERS COMPENSATION
WV
Enumeration date
05/23/2006
Last updated
09/02/2016
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