Individual
SARA ASHLEY BOTTERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1901 CONNECTICUT AVE S, SARTELL, MN 56377-2554
(320) 259-4100
(320) 257-5523
Mailing address
1901 CONNECTICUT AVE S, SARTELL, MN 56377-2554
(320) 259-4100
(320) 257-5523
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0101244146
VA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
65017
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881809549
—
MN
05
—
1881809549
—
VA
01
—
P00686666
MEDICARE RAILROAD
VA
Enumeration date
05/14/2007
Last updated
05/20/2020
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