| Koski Stark Ghodge Llc | |
|
8014 Highway 55 # 515 Golden Valley MN 55427-4712 | |
| (763) 200-1185 | |
| (763) 374-3201 |
| Full Name | Koski Stark Ghodge Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8014 Highway 55 # 515, Golden Valley, Minnesota |
| Authorized Official Name and Position | Paresh S Ghodge (OWNER) |
| Authorized Official Contact | 2054137893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koski Stark Ghodge Llc 8014 Highway 55 # 515 Golden Valley MN 55427-4712 Ph: (763) 200-1185 | Koski Stark Ghodge Llc 8014 Highway 55 # 515 Golden Valley MN 55427-4712 Ph: (763) 200-1185 |
| NPI Number | 1134640477 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 03/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134640477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 22922 (Minnesota) | Primary |
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