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1073868196
BOUNCHANH SOURIYAVONG
NASHVILLE, TN
NPI
1073868196
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: TN 36827)
Enumeration Date
2012-07-14
Last Update Date
2012-07-14
Business Address
-- BOUNCHANH SOURIYAVONG PharmD
1211 MEDICAL CENTER DR
NASHVILLE, TN 37232-0004
Phone number: 615-343-0608
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Mailing Address
-- BOUNCHANH SOURIYAVONG PharmD
2804 BRIGHTWOOD AVE
NASHVILLE, TN 37212-5821
Phone number: 615-585-6642
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