Individual
KELLY KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7601 WAYZATA BLVD, MINNEAPOLIS, MN 55426-1623
(612) 223-8898
Mailing address
8933 XERXES AVE S, BLOOMINGTON, MN 55431-1957
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
09/02/2023
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