Organization
SUMMIT ADVANCE MOBILE WOUND CARE LLC
Active
Organization
SUMMIT ADVANCE MOBILE WOUND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY MOMANYI NP (NURSE PRACTITIONER)
(612) 598-8555
Entity
Organization
Contact information
Practice address
6773 DEERWOOD LN N, MAPLE GROVE, MN 55369-5530
(612) 598-8555
Mailing address
6773 DEERWOOD LN N, MAPLE GROVE, MN 55369-5530
(612) 598-8555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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