Individual
CABDICASIIS CILMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
44 28TH AVE N SUITE J, SAINT CLOUD, MN 56303
(612) 876-5503
Mailing address
44 28TH AVE N STE J, SAINT CLOUD, MN 56303-4259
(612) 876-5503
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
163WH0200X
MN
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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