Individual
MUYCHI TIMOTHY VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
11217 COMMERCE DR N, CHAMPLIN, MN 55316-3122
(763) 427-5474
Mailing address
11217 COMMERCE DR N, CHAMPLIN, MN 55316-3122
(763) 427-5474
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3695
MN
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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