Individual
RILEY OSTERTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2330 SIOUX TRL NW, PRIOR LAKE, MN 55372-9077
(952) 496-6150
(952) 233-4224
Mailing address
2330 SIOUX TRL NW, PRIOR LAKE, MN 55372-9077
(952) 496-6150
(952) 233-4224
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11694
MN
Other
Enumeration date
10/22/2014
Last updated
07/22/2015
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