Individual
JESTINO K KABBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 BASS LAKE RD STE 211, BROOKLYN CENTER, MN 55429-3065
(612) 225-8107
Mailing address
3300 BASS LAKE RD STE 211, BROOKLYN CENTER, MN 55429-3065
(612) 225-8107
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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