Individual
MR. OLUGBENGA OLALEKAN BANJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1160 CHICAGO AVE, ST PAUL PARK, MN 55071-1344
(651) 210-9638
Mailing address
1160 CHICAGO AVE, ST PAUL PARK, MN 55071-1344
(651) 210-9638
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
413980
MN
Other
Enumeration date
10/18/2023
Last updated
10/19/2023
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