Individual
BRITTANY KHAMPHILAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3000
(904) 265-8181
Mailing address
PO BOX 960482, OKLAHOMA CITY, OK 73196-0482
(855) 686-8430
(904) 265-8181
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200771
LA
Other
Enumeration date
12/03/2014
Last updated
08/13/2019
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