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1235698606
PHANTAPHONE KHAMPHOUMY
SALT LAKE CITY, UT
NPI
1235698606
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-03-15
Last Update Date
2019-03-15
Business Address
PHANTAPHONE KHAMPHOUMY
344 E 100 S
SALT LAKE CITY, UT 84111-1700
Phone number: 801-322-3222
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Mailing Address
PHANTAPHONE KHAMPHOUMY
344 E 100 S
SALT LAKE CITY, UT 84111-1700
Phone number: 801-322-3222
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