Individual
PORTIA DADZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2834 BOBCAT TRL NW, PRIOR LAKE, MN 55372-4500
(612) 441-7553
Mailing address
2834 BOBCAT TRL NW, PRIOR LAKE, MN 55372-4500
(612) 441-7553
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/14/2023
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