Individual
SOMPHET TOOK MANIVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
10701 EAST BLVD 111 E (W), CLEVELAND, OH 44106-1702
(216) 791-3800
(216) 231-3447
Mailing address
10701 EAST BLVD, CLEVELAND, OH 44106-1702
(216) 791-3800
(216) 231-3447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.08126-NP
OH
Other
Enumeration date
11/02/2006
Last updated
07/08/2007
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