PHANOMVAN PONGDARA

LINCOLN, NE
NPI1205626595
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2025-05-09
Last Update Date2025-05-09
Business Address
PHANOMVAN PONGDARA
5030 LOCUST ST
LINCOLN, NE 68516-1247
Phone number: 952-452-1202
Mailing Address
PHANOMVAN PONGDARA
5030 LOCUST STREET LINCOLN, NE 68516
LINCOLN, NE 68516-1247
Phone number: 952-452-1202
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