Individual
AMY LARAYNE OOTHOUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STS PROVIDER
Contact information
Practice address
13392 THOMAS DR, LITTLE FALLS, MN 56345-6110
(320) 630-7821
Mailing address
13392 THOMAS DR, LITTLE FALLS, MN 56345-6110
(320) 630-7821
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
383814
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383814
STS NUMBER
MN
Enumeration date
10/13/2020
Last updated
10/13/2020
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