Individual
TERENCE AYEAH KOMTANGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
925 ALYSHEBA RD APT 104, SHAKOPEE, MN 55379-4913
(952) 356-4336
Mailing address
925 ALYSHEBA RD APT 104, SHAKOPEE, MN 55379-4913
(952) 356-4336
(651) 395-5142
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
MN
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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