PHOUTHOVONG SOUTHIYANON

SACRAMENTO, CA
NPI1174740922
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2007-04-20
Last Update Date2007-07-08
Business Address
-- PHOUTHOVONG SOUTHIYANON
601 NORTH MARKET BLVD STE 100 NORTHGATE POINT RST
SACRAMENTO, CA 95834
Phone number: 916-567-4222
Mailing Address
-- PHOUTHOVONG SOUTHIYANON
601 NORTH MARKET BLVD STE 100
SACRAMENTO, CA 95834
Phone number: 916-567-4222