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Individual

LISA SANDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
6381 OSGOOD AVE N BLDG C, STILLWATER, MN 55082-6118
(651) 238-0435
(651) 383-4544
Mailing address
9207 SAINT CROIX TRL N, STILLWATER, MN 55082-4267
(651) 238-0435
(651) 383-4544

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103330
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
670000488
MEDICARE PTAN
MN
Enumeration date
06/29/2007
Last updated
06/26/2020
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