Organization
OTRHOPEDIC SPECIALISTS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIM M NASETH (ACCOUNTING)
(952) 915-8322
Entity
Organization
Contact information
Practice address
14655 GALAXIE AVE, APPLE VALLEY, MN 55124-8575
(952) 915-8322
(952) 920-2561
Mailing address
6600 FRANCE AVE S, SUITE 605, EDINA, MN 55435-1807
(952) 915-8322
(952) 920-2561
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
21645
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053218500
—
MN
Enumeration date
02/22/2008
Last updated
08/10/2010
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