Individual
KOM HER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2456 GUNFLINT TRL, BROOKLYN PARK, MN 55444-1662
(559) 906-2841
Mailing address
2456 GUNFLINT TRL, BROOKLYN PARK, MN 55444-1662
(559) 906-2841
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
MN
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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