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Individual

SOUTHONE SUE PHRATHANY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2616 SE 18TH ST, DES MOINES, IA 50320-1205
(515) 868-7405
Mailing address
2616 SE 18TH ST, DES MOINES, IA 50320-1205
(515) 868-7405

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
IA

Other

Enumeration date
02/27/2017
Last updated
02/27/2017
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