KEOVIENGKHONE MERINA HAKVONGSA

DETROIT, MI
NPI1992804660
Former NameKEOVIENGKHONE MERINA LATIMER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MI  4704212195)
Enumeration Date2006-09-21
Last Update Date2015-01-08
Business Address
-- KEOVIENGKHONE MERINA HAKVONGSA NP
22201 MOROSS RD SUITE 150
DETROIT, MI 48236-2169
Phone number: 586-247-4300
Mailing Address
-- KEOVIENGKHONE MERINA HAKVONGSA NP
45640 SCHOENHERR RD SUITE B
SHELBY TOWNSHIP, MI 48315-6033
Phone number: 586-247-4300