Individual
BAO TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2405 8TH ST S STE 200, MOORHEAD, MN 56560-4200
(218) 331-4866
Mailing address
2405 8TH ST S STE 200, MOORHEAD, MN 56560-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14361
MN
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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