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1326462003
KELLY PHOUNGPHOL
MILWAUKEE, WI
NPI
1326462003
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-02-14
Last Update Date
2014-02-14
Business Address
-- KELLY PHOUNGPHOL
820 N PLANKINTON AVE
MILWAUKEE, WI 53203-1802
Phone number: 414-225-1573
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Mailing Address
-- KELLY PHOUNGPHOL
820 N PLANKINTON AVE
MILWAUKEE, WI 53203-1802
Phone number: 414-225-1573
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