NICK SENGSOUKANE BACCAM

DES MOINES, IA
NPI1851837405
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IA  083495)
Enumeration Date2017-01-06
Last Update Date2017-02-23
Business Address
-- NICK SENGSOUKANE BACCAM
701 RIVERVIEW ST
DES MOINES, IA 50316-2343
Phone number: 515-226-1106
Mailing Address
-- NICK SENGSOUKANE BACCAM
336 FLEETWOOD DR
DES MOINES, IA 50315-2835
Phone number: 319-361-6039
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