Individual
SALAD M ISMAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
810 4TH AVE S STE 204, MOORHEAD, MN 56560-2800
(612) 876-0814
Mailing address
810 4TH AVE S STE 204, MOORHEAD, MN 56560-2800
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
S649195558919
MN
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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