Individual
MR. PHU CAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1596 GARY PL, SAINT PAUL, MN 55119-4238
(763) 318-6040
Mailing address
1596 GARY PL, SAINT PAUL, MN 55119-4238
(763) 318-6040
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
D134053978008
MN
372600000X
Adult Companion
D134053978008
MN
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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