Individual
ERIC HAQUE KHONDAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 COLLEGE ST, BELOIT, WI 53511-5509
(319) 931-3649
Mailing address
700 COLLEGE ST, BELOIT, WI 53511-5509
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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