Individual
FATIMA F JALLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2513 N MAIN ST, RACINE, WI 53402-4417
(262) 681-1464
Mailing address
2513 N MAIN ST, RACINE, WI 53402-4417
(262) 681-1464
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310590-31
WI
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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