BOONMA PHOMMALAYVANE

RANCHO CUCAMONGA, CA
NPI1972923332
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2014-04-23
Last Update Date2014-04-23
Business Address
-- BOONMA PHOMMALAYVANE
8218 9TH ST
RANCHO CUCAMONGA, CA 91730-5031
Phone number: 909-731-6206
Mailing Address
-- BOONMA PHOMMALAYVANE
8218 9TH ST
RANCHO CUCAMONGA, CA 91730-5031
Phone number: 909-731-6206
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