Individual
DA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
379 UNIVERSITY AVE W STE 214, SAINT PAUL, MN 55103-2060
(651) 665-0226
(651) 204-0826
Mailing address
2176 6TH ST E, SAINT PAUL, MN 55119-3919
(651) 665-0226
(651) 204-0826
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
MN
Other
Enumeration date
03/26/2008
Last updated
03/26/2008
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