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Ami Komlanvi, PA-C

Physician Assistant in Lakeville, MN. Individual provider (NPI-1).

NPI number1265874366
StatusActive
Last updated in NPPESNov 2, 2022

Details

NPI
1265874366
Entity type
Individual (NPI-1)
Name
Ami Komlanvi
Credential
PA-C
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 18, 2013
Certification date
Nov 2, 2022
Last updated
Nov 2, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant11347MNYes

Practice location

18580 Joplin Ave
Lakeville, MN 55044-4218

Phone 952-892-9500

Mailing address

18580 Joplin Ave
Lakeville, MN 55044-4218

Phone 952-892-9500

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