Individual
MARIAM ISSAC ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6064 SOUTHPOINTE DR, BURLINGTON, KY 41005-8528
(619) 822-5621
Mailing address
6064 SOUTHPOINTE DR, BURLINGTON, KY 41005-8528
(619) 822-5621
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
4720
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100592580
—
KY
Enumeration date
05/14/2019
Last updated
05/14/2019
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