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Individual

LILLIAN MUSUNGU SHIRAKU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12970 63RD AVE N, MAPLE GROVE, MN 55369-6001
(507) 513-1860
Mailing address
1363 10TH ST NW APT 301, SAINT PAUL, MN 55112-6747
(507) 513-1860

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary

Other

Enumeration date
09/08/2020
Last updated
09/08/2020
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