CHANCHAI TIVITMAHAISOON

LOGAN, WV
NPI1508820549
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: WV  11491)
Enumeration Date2006-04-14
Last Update Date2007-07-08
Business Address
-- CHANCHAI TIVITMAHAISOON M.D.
20 HOSPITAL DR
LOGAN, WV 25601-3452
Phone number: 304-831-1254
Mailing Address
-- CHANCHAI TIVITMAHAISOON M.D.
20 HOSPITAL DR
LOGAN, WV 25601-3452
Phone number: 304-831-1254
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