Individual
ADDISON THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18212 79TH PL N, MAPLE GROVE, MN 55311-1911
(763) 291-0903
Mailing address
18212 79TH PL N, MAPLE GROVE, MN 55311-1911
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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