Individual
IBRAHIM AHSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1105 WI-16, LA CROSSE, WI 54601
(608) 779-0939
Mailing address
1010 BERRY AVE APT 218, TOMAH, WI 54660-4464
(608) 387-1924
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18619-40
WI
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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