| Path Wave Care Center LLC | |
|
2515 S 9th St Apt 702 Minneapolis MN 55406-1034 | |
| (612) 978-1273 | |
| Not Available |
| Full Name | Path Wave Care Center LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 2515 S 9th St Apt 702, Minneapolis, Minnesota |
| Authorized Official Name and Position | Liban Mohamed Jama (OWNER) |
| Authorized Official Contact | 6129781273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Path Wave Care Center LLC 2515 S 9th St Apt 702 Minneapolis MN 55406-1034 Ph: (612) 978-1273 | Path Wave Care Center LLC 2515 S 9th St Apt 702 Minneapolis MN 55406-1034 Ph: (612) 978-1273 |
| NPI Number | 1245053222 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245053222 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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