Individual
MR. YASSIR K IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 CONLIFFE AVE SW APT 203, FARIBAULT, MN 55021-5792
(507) 491-2300
Mailing address
800 CONLIFFE AVE SW APT 203, FARIBAULT, MN 55021-5792
(507) 491-2300
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0063538
HOME CARE
MN
Enumeration date
04/08/2022
Last updated
04/08/2022
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