Individual
SAITHONG VONGPANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1221 S 21ST ST, MANITOWOC, WI 54220-4918
(920) 242-1332
Mailing address
1221 S 21ST ST, MANITOWOC, WI 54220-4918
(920) 242-1332
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
313028031
WI
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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