WILSON KEUNGKHAMPHONG

SHAWNEE, KS
NPI1730507492
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: KS  18-01030)
Enumeration Date2014-03-31
Last Update Date2014-03-31
Business Address
-- WILSON KEUNGKHAMPHONG COTA
21513 W 50TH ST
SHAWNEE, KS 66226-9793
Phone number: 913-207-9383
Mailing Address
-- WILSON KEUNGKHAMPHONG COTA
21513 W 50TH ST
SHAWNEE, KS 66226-9793
Phone number: 913-207-9383
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