Individual
DR. VILAILACK KHEUAKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3600 30TH ST, DES MOINES, IA 50310-5753
(515) 699-5999
Mailing address
1605 E BELL AVE, DES MOINES, IA 50320-1135
(515) 822-3969
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23405
IA
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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