Individual
GODWIN LALE OLLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 GRAND AVE, SHOREVIEW, MN 55126-3006
(651) 795-1348
Mailing address
222 GRAND AVE, SHOREVIEW, MN 55126-3006
(651) 795-1348
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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