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1477149730
AMY VONGVILATH LANE
HUNTERSVILLE, NC
NPI
1477149730
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NC 5013901)
Enumeration Date
2020-12-21
Last Update Date
2020-12-21
Business Address
AMY VONGVILATH LANE F-NP
13808 PROFESSIONAL CENTER DR
HUNTERSVILLE, NC 28078-7948
Phone number: 704-377-0246
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Mailing Address
AMY VONGVILATH LANE F-NP
13808 PROFESSIONAL CENTER DR
HUNTERSVILLE, NC 28078-7948
Phone number: 704-377-0246
Copy
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