Individual
SAL SENETHAVISUOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4235 ARUBA DR, COLUMBUS, OH 43230-5116
(614) 316-2777
Mailing address
4235 ARUBA DR, COLUMBUS, OH 43230-5116
(614) 316-2777
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
33021667
OH
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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