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General NPI Number Information
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NPI Number | 1114755386
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Entity Type | Organization
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Legal Business Name | MIDWEST STABILIZATION SERVICES INC
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 1845 UNIVERSITY AVE W UNIT W415
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City | SAINT PAUL
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State | MN
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Zip | 55104-4563
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Country | US
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Telephone | 651-417-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 1845 UNIVERSITY AVE W UNIT W415
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City | SAINT PAUL
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State | MN
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Zip | 55104-4563
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | ABDINUR MOHAMUD
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Credential |
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Telephone | 651-417-3001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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