Individual
KHURSHID KURBANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5174 ANTON DR APT 2, FITCHBURG, WI 53719-1797
(347) 278-2336
Mailing address
5174 ANTON DR APT 2, FITCHBURG, WI 53719-1797
(347) 278-2336
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
258317
WI
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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