Individual
INDRE LITHYOUVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2321 ATHERHOLT RD, LYNCHBURG, VA 24501-2113
(434) 947-3993
Mailing address
2321 ATHERHOLT RD, LYNCHBURG, VA 24501-2113
(434) 485-7382
(844) 689-3110
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0110-005957
VA
363A00000X
Physician Assistant
Primary
0110-005957
VA
Other
Enumeration date
10/04/2017
Last updated
04/01/2026
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