SearchMinnesota172A00000X

Lao Pha

NPI 1245639301 · on the registry since 2014

Practice

Address
171 Lake St N # 102
Big Lake, MN 55309
Phone
(651) 774-1166
Organisation at this address
Apple Ride Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
172A00000X
172A00000X
Licence states on file
MN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-08-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota