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Contact Information

JOHN BOETTGER
15350 ENGLISH AVE
APPLE VALLEY, MN55124
 Phone: 952-431-8500
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JOHN BOETTGER · (Male)

NPI Number 1053807719
Status Active
Credentials
Entity Individual
Enumeration date 07/06/2018
Last updated 10/09/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MN License # 12718
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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