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1013498872
NEBIYU JAMAL FANTA
SAINT PAUL, MN
NPI
1013498872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172A00000X Driver
(Licence: MN M153136798609)
Enumeration Date
2018-08-28
Last Update Date
2018-08-28
Business Address
NEBIYU JAMAL FANTA
478 UNIVERSITY AVE W
SAINT PAUL, MN 55103-1935
Phone number: 202-779-8511
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Mailing Address
NEBIYU JAMAL FANTA
478 UNIVERSITY AVE W
SAINT PAUL, MN 55103-1935
Phone number: 202-779-8511
Copy
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