Individual
MR. UNKNOWN AZHARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
5810 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416
(952) 927-8686
(952) 927-8687
Mailing address
5810 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416
(952) 927-8686
(952) 927-8687
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
05/14/2010
Last updated
05/21/2010
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