Individual
KHOA A HO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S, LAT, ATC
Contact information
Practice address
8100 W 78TH ST STE 230, EDINA, MN 55439-2570
(952) 946-9777
Mailing address
10587 BOSS CIR, EDEN PRAIRIE, MN 55347-5228
(952) 212-6316
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2000034938
MN
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/22/2017
Last updated
05/29/2025
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