Individual
CHANDA DALIDA VONGPRASERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15978 HYLAND POINTE CT, APPLE VALLEY, MN 55124-7063
(952) 432-5145
Mailing address
15978 HYLAND POINTE CT, APPLE VALLEY, MN 55124-7063
(952) 432-5145
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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