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302 Highway 75 N Ste 200 Moorhead MN 56560-2474 | |
| (612) 701-6780 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 302 Highway 75 N Ste 200, Moorhead, Minnesota |
| Authorized Official Name and Position | Abdullahi Issa (OWNER) |
| Authorized Official Contact | 6127016780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
302 Highway 75 N Ste 200 Moorhead MN 56560-2474 Ph: (612) 701-6780 | 302 Highway 75 N Ste 200 Moorhead MN 56560-2474 Ph: (612) 701-6780 |
| NPI Number | 1629791405 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 11/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629791405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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