Individual
CONNOR FAWKES MANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 FREEWAY BLVD STE 204, MINNEAPOLIS, MN 55430-1751
(763) 412-1996
(763) 292-5653
Mailing address
7030 BROOKLYN BLVD, MINNEAPOLIS, MN 55429-1370
(612) 408-7733
(763) 292-5653
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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