Most Relevant Information
Provider Data
| NPI Number: | 1003635657 |
| Provider Name: | MAXWELL VANG |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/09/2024 |
| Last Updated: | 10/09/2024 |
Provider Practice Location
18334 JOPLIN ST NW
ELK RIVER
MN
553301773
Practice Location Phone/Fax
| Phone: | 6122300308 |
| Fax: |
Provider Mailing Location
20299 ENGEN BLVD NW
NOWTHEN
MN
553308020
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |