Individual
PHENG THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1227 N 9TH ST, SHEBOYGAN, WI 53081-3407
(920) 395-2025
(920) 783-6033
Mailing address
1227 N 9TH ST, SHEBOYGAN, WI 53081-3407
(920) 395-2025
(920) 783-6033
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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