Individual
TAMARA GLEE OTTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14650 GARRETT AVE, APPLE VALLEY, MN 55124-7543
(952) 236-2000
Mailing address
21109 HONEYCOMB WAY, LAKEVILLE, MN 55044-6401
(612) 308-2349
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A965
MN
Other
Enumeration date
09/07/2023
Last updated
09/08/2023
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