LAVANTRE PHAVORACHITH

FRESNO, CA
NPI1720653900
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy164X00000X Licensed Vocational Nurse
(Licence: CA  VN717375)
Enumeration Date2021-05-21
Last Update Date2023-05-03
Business Address
LAVANTRE PHAVORACHITH
4411 E KINGS CANYON RD
FRESNO, CA 93702-3604
Phone number: 559-453-1008
Mailing Address
LAVANTRE PHAVORACHITH
4411 E KINGS CANYON RD
FRESNO, CA 93702-3604
Phone number: 559-453-1008