Individual
DR. TONY KONG MOUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4800 HIGHWAY 61 N, WHITE BEAR LAKE, MN 55110-2844
(651) 762-3864
Mailing address
3480 ENGLISH ST, VADNAIS HEIGHTS, MN 55110-5204
(651) 230-7857
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124929
MN
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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