Individual
VICHAI THANUPAKORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 8TH ST SW, ALTOONA, IA 50009-1760
(515) 967-3765
Mailing address
108 8TH ST SW, ALTOONA, IA 50009-1760
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22749
IA
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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