Provider Demographics
NPI:1508331588
Name:ALIMO, WILLIAM
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:ALIMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6537 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1725
Mailing Address - Country:US
Mailing Address - Phone:612-298-5487
Mailing Address - Fax:
Practice Address - Street 1:6603 QUEEN AVE S STE G
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2000
Practice Address - Country:US
Practice Address - Phone:612-869-3556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN171W00000X
171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor