Individual
DAM SOUKSAWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 EMPIRE DR, SUITE 123, SAINT PAUL, MN 55103-1856
(651) 222-2787
(651) 224-1057
Mailing address
617 PERSHING BLVD, WORTHINGTON, MN 56187-1261
(507) 376-4245
(651) 224-1057
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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