Individual
MISS MONGTU THI NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 N FRANKLIN ST APT A2, MADISON, WI 53703-2345
(248) 633-3177
Mailing address
22 N FRANKLIN ST APT A2, MADISON, WI 53703-2345
(248) 633-3177
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4928-23
WI
Other
Enumeration date
05/31/2019
Last updated
05/01/2023
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