Individual
CHAJLI CHEN THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 586-5844
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/11/2025
Last updated
08/21/2025
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