Individual
SHAKUR ABDISALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1440 E OLD SHAKOPEE RD, BLOOMINGTON, MN 55425-2438
(952) 201-4493
Mailing address
1440 E OLD SHAKOPEE RD, BLOOMINGTON, MN 55425-2438
(952) 201-4493
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
397226
MN
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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