Individual
NASRA ALI FARAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4736 123RD LN NE, BLAINE, MN 55449-6238
(612) 308-6732
Mailing address
4736 123RD LN NE, BLAINE, MN 55449-6238
(612) 308-6732
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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