Individual
IBRAHIM IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
562 HUSET PKWY NE, COLUMBIA HEIGHTS, MN 55421-5030
(612) 363-4252
Mailing address
562 HUSET PKWY NE, COLUMBIA HEIGHTS, MN 55421-5030
(612) 363-4252
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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