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1447909346
PHONPHANH DEDTHANOU
MORGANTOWN, WV
NPI
1447909346
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-03-20
Last Update Date
2022-03-20
Business Address
PHONPHANH DEDTHANOU DO
1 MEDICAL CENTER DR 1310 HSC
MORGANTOWN, WV 26506
Phone number: 304-293-2342
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Mailing Address
PHONPHANH DEDTHANOU DO
130 RED MULBERRY WAY APT 2
CHARLESTON, WV 25306-6317
Phone number: 515-779-4571
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