Individual
SOUTSADA SOUNTHONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20717 VETERANS DR, ELKHORN, NE 68022-6971
(616) 403-9452
Mailing address
20717 VETERANS DR, ELKHORN, NE 68022-6971
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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