Individual
DR. PETER SONEPHET PHOUMMAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
14111 KING RD STE 410, FRISCO, TX 75036-0810
(901) 496-3095
Mailing address
14111 KING RD STE 410, FRISCO, TX 75036-0810
(901) 496-3095
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
15714
TX
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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