# NORTHSIDE RESOURCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346647773
- **Authorized official:** MR. ABSHIR MOHAMED (OWNER)
- **Authorized official phone:** (612) 709-1440

## Contact information

- **Practice address:** 526 121ST AVE NE, BLAINE, MN 55434-3380
- **Practice address phone:** (612) 709-1440
- **Mailing address:** 2733 PARK AVE, MINNEAPOLIS, MN 55407-1008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2014
- **Last updated:** 06/29/2015