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Individual

JASON ANDREW GOHR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1263 OTTAWA AVE, WEST ST PAUL, MN 55118-2017
(612) 239-0193
Mailing address
1263 OTTAWA AVE, WEST ST PAUL, MN 55118-2017
(612) 239-0193

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
T020254820802
MN

Other

Enumeration date
02/23/2022
Last updated
02/23/2022
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