Individual
IFTU ABDULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 81ST AVE NE APT 6, SPRING LAKE PARK, MN 55432-1342
(763) 400-0851
Mailing address
1600 81ST AVE NE APT 6, SPRING LAKE PARK, MN 55432-1342
(763) 400-0851
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3826970
DOT
MN
Enumeration date
08/06/2022
Last updated
08/06/2022
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