Provider Demographics
NPI:1457735797
Name:HO, LANG MITCHELL DAC (DPT)
Entity Type:Individual
Prefix:
First Name:LANG
Middle Name:MITCHELL DAC
Last Name:HO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14101 FAIRVIEW DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4590
Mailing Address - Country:US
Mailing Address - Phone:952-892-2650
Mailing Address - Fax:952-892-2654
Practice Address - Street 1:14101 FAIRVIEW DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4590
Practice Address - Country:US
Practice Address - Phone:952-892-2650
Practice Address - Fax:952-892-2654
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN4130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist