Individual provider · NPI-1
John A Momoh
Technician, Personal Care Attendant · Brooklyn Park, MN
NPI number1750565362
StatusActive
Last updated in NPPESDec 19, 2007
Details
- NPI
- 1750565362
- Entity type
- Individual (NPI-1)
- Name
- John A Momoh
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 19, 2007
- Last updated
- Dec 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | 97694 | MN | Yes |
| 374U00000X | Home Health Aide | 97694 | MN |
Practice location
7710 Brooklyn Blvd #109Brooklyn Park, MN 55443-2966
Phone 763-566-0544 · Fax 763-566-5577
Mailing address
7710 Brooklyn Blvd #109Brooklyn Park, MN 55443-2966
Phone 763-566-0544 · Fax 763-566-5577
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