Individual
GEMADO KOJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6511 HUMBOLDT AVE N, BROOKLYN CENTER, MN 55430-1860
(763) 746-6677
Mailing address
6511 HUMBOLDT AVE N, BROOKLYN CENTER, MN 55430-1860
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M543192029312
DL
MN
Enumeration date
12/16/2010
Last updated
12/16/2010
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