Individual
NEIL LAITALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5755 152ND ST # BT, MILACA, MN 56353-3975
(763) 244-0761
Mailing address
5755 152ND ST # BT, MILACA, MN 56353-3975
(763) 244-0761
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
BC270850
MN
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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