Individual
MOHAMED IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2195 S JOLIET ST, AURORA, CO 80014-1034
(720) 936-5606
Mailing address
2195 S JOLIET ST, AURORA, CO 80014-1034
(720) 936-5606
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
11-314-0189
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000178887
—
CO
Enumeration date
02/08/2023
Last updated
02/08/2023
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