Individual
IBRAHIM BANGALY FOFANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DRIVER
Contact information
Practice address
10911 RHODE ISLAND CIR N, CHAMPLIN, MN 55316-3256
(763) 232-6365
Mailing address
10911 RHODE ISLAND CIR N, CHAMPLIN, MN 55316-3256
(763) 232-6365
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/25/2025
Last updated
03/07/2025
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