Individual
KONG MENG YANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 GREENWOOD AVE LOT 26, TRACY, MN 56175
(763) 276-5167
Mailing address
6912 LOMBARDY LN, CRYSTAL, MN 55428-2947
(763) 276-5167
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38
HOME HEALTH
MN
Enumeration date
03/05/2018
Last updated
06/16/2018
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