Individual
MUNTAHA Y ISSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9220 BASS LAKE RD STE 395, NEW HOPE, MN 55428-3110
(763) 400-6350
(763) 201-3797
Mailing address
9220 BASS LAKE RD STE 395, NEW HOPE, MN 55428-3110
(763) 400-6350
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84-3654226
—
MN
Enumeration date
11/12/2019
Last updated
04/16/2020
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