Individual
GAMMACHIS BOKKU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
736 66TH AVE N, BROOKLYN CENTER, MN 55430-1611
(763) 587-8890
Mailing address
736 66TH AVE N, BROOKLYN CENTER, MN 55430-1611
(763) 587-8890
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-2951610
—
MN
Enumeration date
10/05/2021
Last updated
10/05/2021
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