Individual
SUPANAWONG XIONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1515 GOLF RD, EAU CLAIRE, WI 54701-7457
(651) 274-6118
Mailing address
1515 GOLF RD, EAU CLAIRE, WI 54701-7457
(651) 274-6118
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
X5207800017205
WI
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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