Individual
DOREEN LUBI ISUBIKALU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 SIOUX TRAIL NW, PRIOR LAKE, MN 55372
(952) 496-6150
Mailing address
8033 JOCELYN AVE S, COTTAGE GROVE, MN 55016
(651) 707-6130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5160
MN
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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