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1629304654
THIRATH MARK LUONG
EAGAN, MN
NPI
1629304654
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MN 10898)
Enumeration Date
2009-10-27
Last Update Date
2022-07-21
Business Address
-- THIRATH MARK LUONG PA-C
2620 EAGAN WOODS DR STE 100
EAGAN, MN 55121-1138
Phone number: 651-968-5230
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Mailing Address
-- THIRATH MARK LUONG PA-C
710 COMMERCE DR STE 200
WOODBURY, MN 55125-4925
Phone number: 651-968-5042
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