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Individual

MAI LOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5830 LOGAN AVE N APT 9, BROOKLYN CENTER, MN 55430-2662
(763) 503-3911
Mailing address
5830 LOGAN AVE N APT 9, BROOKLYN CENTER, MN 55430-2662
(763) 503-3911

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
A9279728500
MN

Other

Enumeration date
05/02/2007
Last updated
07/08/2007
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