Individual
DIEGO MCKAY BOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3541 MINNEHAHA AVE APT 1, MINNEAPOLIS, MN 55406-2697
(612) 434-7001
Mailing address
3541 MINNEHAHA AVE, MINNEAPOLIS, MN 55406-2696
(612) 434-7001
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
J000-030-241-400
MN
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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