Individual
KENYI OKUCU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1490 148TH AVE NW, ANDOVER, MN 55304-3459
(612) 401-8145
Mailing address
1490 148TH AVE NW, ANDOVER, MN 55304-3459
(612) 401-8145
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
MN
343900000X
Non-emergency Medical Transport (VAN)
Primary
343900000X
MN
Other
Enumeration date
09/07/2018
Last updated
09/08/2018
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