PORNTHEP PRATHANVANICH

MAYWOOD, IL
NPI1093109308
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy208600000X Surgery
(Licence: IL  125066961)
Enumeration Date2015-03-25
Last Update Date2015-05-29
Business Address
-- PORNTHEP PRATHANVANICH M.D.
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 888-584-7888
Mailing Address
-- PORNTHEP PRATHANVANICH M.D.
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 888-584-7888