Individual
MACIE KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
521 HEMLOCK ST, WOODRUFF, WI 54568-9197
(715) 358-6650
Mailing address
PO BOX 2195, WOODRUFF, WI 54568-2195
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10020-146
WI
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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