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1770133175
LAURA BERGSTROM
LAKE ELMO, MN
NPI
1770133175
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Former Name
LAURA WOLTER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 13671)
Enumeration Date
2019-09-17
Last Update Date
2024-08-23
Business Address
LAURA BERGSTROM PA
8515 EAGLE POINT BLVD
LAKE ELMO, MN 55042-8624
Phone number: 612-879-1000
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Mailing Address
LAURA BERGSTROM PA
3601 MINNESOTA DR STE 200
BLOOMINGTON, MN 55435-5281
Phone number: 612-879-1000
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