Individual
MRS. KELLY GOHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
540 RIPLEY AVE, MAPLEWOOD, MN 55117-2480
(651) 246-7175
Mailing address
540 RIPLEY AVE, MAPLEWOOD, MN 55117-2480
(651) 246-7175
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1071138-1-HCBS
MN
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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