Individual
HUSSEN WAKO BUTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2245 IDE CT, MAPLEWOOD, MN 55109-2635
(612) 578-7723
Mailing address
2245 IDE CT, MAPLEWOOD, MN 55109-2635
(612) 578-7723
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
394663
MN
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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