Individual
MRS. LEQUILLA LASH OWN CARR-MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6708 DUTTON AVE, BROOKLYN PARK, MN 55428-2415
(763) 238-7796
Mailing address
6708 DUTTON AVE, BROOKLYN PARK, MN 55428-2415
(763) 238-7796
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
359811
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HA
—
MN
Enumeration date
12/14/2012
Last updated
12/14/2012
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