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Individual

MR. JAMAL ALI OMAR JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
428 CENTRAL AVE W, SAINT PAUL, MN 55103-2248
Mailing address
743 LAFOND AVE, SAINT PAUL, MN 55104-1606
(651) 529-5381

Taxonomy

Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
C153041120609
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
C153041120609
MN
Enumeration date
03/09/2022
Last updated
03/29/2022
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