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Individual

TERRY FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCHIS

Contact information

Practice address
481 E DIVISION ST, STE 900, FOND DU LAC, WI 54935-3748
(920) 926-1288
(920) 926-0533
Mailing address
481 E DIVISION ST, STE 900, FOND DU LAC, WI 54935-3748
(920) 926-1288
(920) 926-0533

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1237-060
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42857500
WI
Enumeration date
06/15/2009
Last updated
09/18/2009
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