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Individual

DESTINY VANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1470 INDUSTRIAL DR NW, ROCHESTER, MN 55901-0700
(507) 322-7751
Mailing address
351 LABORE RD APT 216, LITTLE CANADA, MN 55117-1120
(763) 670-8030

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00045697800
UCARE
MN
Enumeration date
09/09/2021
Last updated
09/09/2021
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