Individual
OMAR FARAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15050 CEDAR AVE 144, APPLE VALLEY, MN 55124-7047
(612) 850-9904
Mailing address
15050 CEDAR AVE 144, APPLE VALLEY, MN 55124-7047
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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