Provider Demographics
NPI:1346902756
Name:WOO, HARVEY (RT(R))
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:
Last Name:WOO
Suffix:
Gender:M
Credentials:RT(R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9627 BLUEGILL RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-8543
Mailing Address - Country:US
Mailing Address - Phone:651-253-7878
Mailing Address - Fax:
Practice Address - Street 1:9627 BLUEGILL RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8543
Practice Address - Country:US
Practice Address - Phone:651-253-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4924792471C1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C1101XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiovascular-Interventional Technology