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Individual

SARAH RIA TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1540 LAKE ST S, FOREST LAKE, MN 55025-2628
(651) 464-7100
Mailing address
1540 LAKE ST S, FOREST LAKE, MN 55025-2628
(651) 464-7100

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
65706
WI
207Q00000X
Family Medicine Physician
Primary
68925
MN

Other

Enumeration date
04/29/2013
Last updated
05/04/2023
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