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NPI Code Detail

MEDICARE: ISUROON

MEDICARE: ISUROON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1154976926
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISUROON
Provider Business Mailing Address
First Line : 1600 E. LAKE ST.
Second Line : SUITE 1
City : MINNEAPOLIS
State : MN
Zip : 55407-1884
Country : US
Telephone Number : 612-886-2731
Fax Number :
Provider Business Practice Location Address
First Line : 1600 E. LAKE ST.
Second Line : SUITE 1
City : MINNEAPOLIS
State : MN
Zip : 55407-1884
Country : US
Telephone Number : 612-886-2731
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : FARTUN WELI
Credential :
Telephone Number : 612-866-2731
Provider Enumeration Date : 08/07/2019
Last Update Date : 04/30/2021

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Directions to “ISUROON ” Practice Location

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