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Individual

ASHA MAHAMUD ISSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 RIVER RIDGE CT, BURNSVILLE, MN 55337-1613
(612) 636-8746
Mailing address
2904 W 135TH ST, BURNSVILLE, MN 55337-2103
(612) 442-2856

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
11/16/2023
Last updated
11/16/2023
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