Individual
MS. LINDA PHENGSAVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 BUCKLAND HILLS DR, MANCHESTER, CT 06042-8701
(860) 327-0083
Mailing address
114 COREY ST, WINDSOR, CT 06095-4519
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PTN.0006998
CT
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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