Individual
SADIA PAULETTA KRUAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6756 GRIMES PL NORTH, BROOKLYN CENTER, MN 55429
(763) 843-1040
Mailing address
6756 GRIMES PL N, BROOKLYN CENTER, MN 55429-1747
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
Q467169839217
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-2391068
—
MN
Enumeration date
08/10/2017
Last updated
08/10/2017
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