Individual
SUAD A DHIISOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1069 GRANDVIEW WAY # 143, COLUMBIA HEIGHTS, MN 55421-3376
(612) 403-1569
Mailing address
1069 GRANDVIEW WAY # 143, COLUMBIA HEIGHTS, MN 55421-3376
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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