Individual
THAI VIET NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10800 E 21ST ST N, WICHITA, KS 67206-3542
(316) 636-4352
Mailing address
10800 E 21ST ST N, WICHITA, KS 67206-3542
(573) 825-6279
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100898
KS
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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