Individual
MAI LEE CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1544 TIMBERLAKE RD, SAINT PAUL, MN 55117-3946
(651) 558-2191
Mailing address
1544 TIMBERLAKE RD, SAINT PAUL, MN 55117-3946
(651) 558-2191
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
12128
MN
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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