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1053193557
AMANDA LYNN FORTIER
COON RAPIDS, MN
NPI
1053193557
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Former Name
AMANDA LYNN KAUKOLA
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 14693)
Enumeration Date
2023-10-18
Last Update Date
2023-10-18
Business Address
AMANDA LYNN FORTIER PA-C
11850 BLACKFOOT ST NW STE 470
COON RAPIDS, MN 55433-2773
Phone number: 651-999-6800
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Mailing Address
AMANDA LYNN FORTIER PA-C
3001 METRO DR STE 460
BLOOMINGTON, MN 55425-1548
Phone number: 651-999-7022
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