Individual
TYDA SAROEUNG ROM KEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
401 HIGHLAND AVE, SOMERVILLE, MA 02144-2516
(833) 510-4357
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN100116
MA
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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