Individual
KONGCHENG VAHCHUAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
12802 E 96TH ST N, OWASSO, OK 74055-5371
(918) 272-7467
Mailing address
11613 N 158TH EAST AVE, COLLINSVILLE, OK 74021-5827
(916) 719-9284
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19919
OK
Other
Enumeration date
12/12/2022
Last updated
12/31/2022
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