MENA K VANHPHOUMY

ELKHART, IN
NPI1740560499
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IN  280293)
Enumeration Date2011-08-25
Last Update Date2011-08-25
Business Address
-- MENA K VANHPHOUMY COTA
3109 E BRISTOL ST
ELKHART, IN 46514-4372
Phone number: 574-612-4708
Mailing Address
-- MENA K VANHPHOUMY COTA
30570 GREGORY DR
ELKHART, IN 46516-1243
Phone number: 574-612-4708