Individual
FAHIM UZZAMAN KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
1900 SOUTH AVE, LA CROSSE, WI 54601-5467
(608) 775-4010
(608) 775-6723
Mailing address
1911 MILLER ST, LA CROSSE, WI 54601-8505
(608) 775-4010
(608) 775-6723
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO02454
MD
224P00000X
Prosthetist
CPO02454
MD
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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