Individual
DAVID MOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11855 ULYSSES ST NE, BLAINE, MN 55434-3947
(763) 634-7601
Mailing address
480 HIGHWAY 96 E, VADNAIS HEIGHTS, MN 55127-2557
(651) 482-8486
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11679
MN
Other
Enumeration date
08/29/2019
Last updated
10/19/2020
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