Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2026-04-03
- Last updated
- 2026-04-03
Licenses
The registry row did not include a license.
Location
- Practice location
- 4825 DOUGLAS DR N
- City
- CRYSTAL MN
- Postal code
- 554293535
- Phone
- 651-755-5026
Organization contact
- Name
- OLAJUMOKE DISU
- Title
- Owner
- Phone
- 6517555026
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.