Organization
HAWOS PCA SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISSE ELMI (DIRECTOR OF OPERATIONS/OWNER)
(612) 232-7640
Entity
Organization
Contact information
Practice address
3201 2ND AVE S, MINNEAPOLIS, MN 55408-3202
(612) 245-0470
Mailing address
3201 2ND AVE S, MINNEAPOLIS, MN 55408-3202
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
MN
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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