Individual
POUA THAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
964 INWOOD AVE N, OAKDALE, MN 55128-6625
(651) 621-2206
(651) 578-8587
Mailing address
6798 HADLEY AVE S, COTTAGE GROVE, MN 55016-1073
(651) 621-2206
(651) 578-8587
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5474
MN
Other
Enumeration date
01/03/2011
Last updated
05/04/2011
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