KHANTALEE SOUVANNAVONG

ROCHESTER, NY
NPI1487042560
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  286904-1)
Enumeration Date2014-12-25
Last Update Date2014-12-25
Business Address
-- KHANTALEE SOUVANNAVONG
185 COUNTRY LN
ROCHESTER, NY 14626-3307
Phone number: 585-749-0292
Mailing Address
-- KHANTALEE SOUVANNAVONG
185 COUNTRY LN
ROCHESTER, NY 14626-3307
Phone number: 585-749-0292
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