Individual
MR. ISAAC LARSEN TADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 KILAUEA AVE STE 105, HILO, HI 96720-3089
(808) 333-3600
Mailing address
90 MALCOLM AVE SE APT 4, MINNEAPOLIS, MN 55414-3545
(507) 589-9171
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2025
Last updated
04/18/2025
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