(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003554148
Provider Name: WIDLYNE DESIR
Entity Type: Individual
Taxonomy Code: 225700000X
Specialty: Massage Therapist
License Number:
Most Important Dates
Enumeration Date: 05/26/2022
Last Updated: 07/20/2024
Provider Practice Location
1121 JACKSON ST NE STE 100
MINNEAPOLIS
MN
554133051
Practice Location Phone/Fax
Phone: 6124055876
Fax:
Provider Mailing Location
PO BOX 6836
SAINT PAUL
MN
551060836
Provider Mailing Phone/Fax
Phone: 6124055876
Fax: