Individual
PETER KAGA OMOT II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 WILSON AVE NE STE 15, SAINT CLOUD, MN 56304-0403
(320) 443-4418
Mailing address
22 WILSON AVE NE STE 15, SAINT CLOUD, MN 56304-0403
(320) 443-4418
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
K811182269510
MN
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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