Individual
IRAM MINUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1330 N SUPERIOR AVE, TOMAH, WI 54660-1130
(608) 372-4111
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036121667
IL
207Q00000X
Family Medicine Physician
Primary
61403
WI
Other
Enumeration date
07/31/2008
Last updated
12/07/2013
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