Individual
SANDZHAR YUSUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
95 WASHINGTON ST, STE #474, CANTON, MA 02021-4006
(781) 821-3411
(781) 634-0508
Mailing address
95 WASHINGTON ST, STE #474, CANTON, MA 02021-4006
(781) 821-3411
(781) 634-0508
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
—
—
Other
Enumeration date
06/10/2016
Last updated
06/10/2016
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