Individual
DR. ABRAHAM W WIDJAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2201 HENNEPIN AVE, MINNEAPOLIS, MN 55405-2738
(612) 377-7760
Mailing address
1770 BRYANT AVE S APT 201, MINNEAPOLIS, MN 55403-3140
(712) 212-1236
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7123
MN
Other
Enumeration date
07/24/2023
Last updated
05/16/2024
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