Male or Other

Khoa Ho LAT, ATC

Athletic Trainer in Blaine, MN(View on Map)

Full Name

Khoa Ho LAT, ATC

NPI Number

1679089841

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/22/2017

Specialties

(Taxonomies)

Code

2255A2300X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

2000034938

Contact
Information

Purpose

Mailing
Location

Address

10587 BOSS CIR
4000 PHEASANT RIDGE DR NE

City

Eden Prairie
Blaine

State

MN
MN

Postal Code

55347-5228
55449-7101

Country

US
US

Telephone Number

(952) 212-6316
(612) 210-7485

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/24/2021

Provider Address

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