Individual
SOUTHIDA UK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8916 W 137TH ST, SAVAGE, MN 55378-2188
(952) 200-8747
Mailing address
8916 W 137TH ST, SAVAGE, MN 55378-2188
(952) 200-8747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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