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1083721641
CHAISAK PENGVANICH
LOUISVILLE, KY
NPI
1083721641
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: KY 17517)
Enumeration Date
2006-08-23
Last Update Date
2007-07-08
Business Address
Dr. CHAISAK PENGVANICH M.D.
1607 DIXIE HWY
LOUISVILLE, KY 40210-1745
Phone number: 502-772-1822
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Mailing Address
Dr. CHAISAK PENGVANICH M.D.
1607 DIXIE HWY
LOUISVILLE, KY 40210-1745
Phone number: 502-772-1822
Copy
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