CHITTADAPHONE PHOUTHAVONG

ROCHESTER, NY
NPI1952600330
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: NY  777030)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: NY  287928)
Enumeration Date2011-03-24
Last Update Date2019-08-19
Business Address
CHITTADAPHONE PHOUTHAVONG RN
111 WESTFALL RD
ROCHESTER, NY 14620-4647
Phone number: 585-353-9305
Mailing Address
CHITTADAPHONE PHOUTHAVONG RN
111 WESTFALL RD
ROCHESTER, NY 14620-4647
Phone number: 585-353-9305