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Individual

MANOSH VONGVISES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
419 TOWN MOUNTAIN RD, SUITE 104, PIKEVILLE, KY 41501-1631
(606) 432-3277
(606) 432-6771
Mailing address
419 TOWN MOUNTAIN RD, SUITE 104, PIKEVILLE, KY 41501-1631
(606) 432-3277
(606) 432-6771

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
20681
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64206816
KY
Enumeration date
09/01/2006
Last updated
07/08/2007
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