Individual
MAI LY THOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
980 RICE ST, SAINT PAUL, MN 55117-4949
(651) 326-9020
Mailing address
980 RICE ST, SAINT PAUL, MN 55117-4949
(651) 326-9020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
72351
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
08/19/2022
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