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Individual

MAI SEE THAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
13819 HANSON BLVD NW, ANDOVER, MN 55304-7608
(763) 392-4001
Mailing address
8508 EMERY PKWY N, CHAMPLIN, MN 55316-2494
(763) 442-7872

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107717
NCCPA ID
MN
Enumeration date
07/30/2007
Last updated
03/27/2017
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