Individual
MAYAR SAMI ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3401 E MEDICINE LAKE BLVD, PLYMOUTH, MN 55441-2307
(612) 200-7352
Mailing address
6115 MANCHESTER AVE NE, OTSEGO, MN 55301-4696
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202001
MN
Other
Enumeration date
03/29/2020
Last updated
03/29/2020
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