Individual
ABDULAHI OSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
248 OAK DR, EAGLE LAKE, MN 56024-3404
(734) 548-2095
Mailing address
248 OAK DR, EAGLE LAKE, MN 56024-3404
(734) 548-2095
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
791703400022
MN
172A00000X
Driver
791703400022
MN
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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