Individual
VONGRETCHEN DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3018 RUSSELL AVE N, MINNEAPOLIS, MN 55411-1017
(612) 314-9059
Mailing address
3018 RUSSELL AVE N, MINNEAPOLIS, MN 55411-1017
(612) 314-9059
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
PCA53420320160525
MN
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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