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1679089841
KHOA HO
BLAINE, MN
NPI
1679089841
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 2000034938)
Enumeration Date
2017-12-22
Last Update Date
2021-08-24
Business Address
KHOA HO LAT, ATC
4000 PHEASANT RIDGE DR NE
BLAINE, MN 55449-7101
Phone number: 612-210-7485
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Mailing Address
KHOA HO LAT, ATC
10587 BOSS CIR
EDEN PRAIRIE, MN 55347-5228
Phone number: 952-212-6316
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