Individual
MOLLY ETTA KOISTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
Mailing address
1700 HIGHWAY 25 N, BUFFALO, MN 55313-1930
(763) 682-1313
(763) 581-9090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14220
MN
Other
Enumeration date
09/29/2022
Last updated
01/18/2023
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