CHAISAK PENGVANICH

LOUISVILLE, KY
NPI1083721641
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207R00000X Internal Medicine
(Licence: KY  17517)
Enumeration Date2006-08-23
Last Update Date2007-07-08
Business Address
Dr. CHAISAK PENGVANICH M.D.
1607 DIXIE HWY
LOUISVILLE, KY 40210-1745
Phone number: 502-772-1822
Mailing Address
Dr. CHAISAK PENGVANICH M.D.
1607 DIXIE HWY
LOUISVILLE, KY 40210-1745
Phone number: 502-772-1822
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