Individual
MRS. KSENIA MARY VONGVIPHUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2225 E EVESHAM RD, VOORHEES, NJ 08043-1557
(856) 795-4330
Mailing address
2225 E. EVESHAM RD, VOORHEES, NJ 08043
(484) 476-2000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/11/2017
Last updated
08/11/2023
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