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Individual

JOHN A MOMOH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7710 BROOKLYN BLVD #109, BROOKLYN PARK, MN 55443-2966
(763) 566-0544
(763) 566-5577
Mailing address
7710 BROOKLYN BLVD #109, BROOKLYN PARK, MN 55443-2966
(763) 566-0544
(763) 566-5577

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
97694
MN
374U00000X
Home Health Aide
97694
MN

Other

Enumeration date
12/19/2007
Last updated
12/19/2007
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