JACK THAMMAVONGSA

FPO, AP
NPI1174848683
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider Independent Duty Corpsman
Enumeration Date2010-03-29
Last Update Date2010-03-29
Business Address
JACK THAMMAVONGSA
3D MED BN, 3D MLG H&S CO UNIT #38447
FPO, AP 96604-8447
Phone number: 315-623-4960
Mailing Address
JACK THAMMAVONGSA
PSC 482 BOX 155
FPO, AP 96362-9998
Phone number:
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