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1992804660
KEOVIENGKHONE MERINA HAKVONGSA
DETROIT, MI
NPI
1992804660
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Former Name
KEOVIENGKHONE MERINA LATIMER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704212195)
Enumeration Date
2006-09-21
Last Update Date
2015-01-08
Business Address
-- KEOVIENGKHONE MERINA HAKVONGSA NP
22201 MOROSS RD SUITE 150
DETROIT, MI 48236-2169
Phone number: 586-247-4300
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Mailing Address
-- KEOVIENGKHONE MERINA HAKVONGSA NP
45640 SCHOENHERR RD SUITE B
SHELBY TOWNSHIP, MI 48315-6033
Phone number: 586-247-4300
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