Individual
MOHAMUD ALI HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15815 FRANKLIN TRL SE STE 502, PRIOR LAKE, MN 55372-2076
(612) 205-2030
Mailing address
15815 FRANKLIN TRL SE STE 502, PRIOR LAKE, MN 55372-2076
(612) 205-2030
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
H508-055-980-813
MN
Other
Enumeration date
08/15/2024
Last updated
08/27/2024
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