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Sompong Khamsomphou

Technician, Personal Care Attendant in Las Vegas, NV. Individual provider (NPI-1).

NPI number1891388872
StatusActive
Last updated in NPPESFeb 19, 2021

Details

NPI
1891388872
Entity type
Individual (NPI-1)
Name
Sompong Khamsomphou
Sex
Female
Sole proprietor
No
Enumeration date
Feb 19, 2021
Certification date
Feb 19, 2021
Last updated
Feb 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3747P1801X Technician, Personal Care Attendant––Yes

Practice location

4080 E Lake Mead Blvd Ste B-111
Las Vegas, NV 89115-6466

Phone 702-531-9344

Mailing address

4080 E Lake Mead Blvd Ste B-111
Las Vegas, NV 89115-6466

Phone 702-531-9344

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