FAHIM UZZAMAN KHAN

LA CROSSE, WI
NPI1235679366
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy222Z00000X 
(Licence: MD  CPO02454)
Additional Taxonomies224P00000X Prosthetist
(Licence: MD  CPO02454)
Enumeration Date2017-03-08
Last Update Date2017-03-08
Business Address
-- FAHIM UZZAMAN KHAN CPO
1900 SOUTH AVE
LA CROSSE, WI 54601-5467
Phone number: 608-775-4010
Mailing Address
-- FAHIM UZZAMAN KHAN CPO
1911 MILLER ST
LA CROSSE, WI 54601-8505
Phone number: 608-775-4010
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