Individual
PATRICIA LY MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4175 VINEWOOD LN N, PLYMOUTH, MN 55442-2624
(763) 553-1757
Mailing address
1501 87TH AVE N, BROOKLYN PARK, MN 55444-1364
(612) 327-6957
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
126829
MN
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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