KHANTHALY PHOMMATA
Individual Provider (NPI-1)
Active
Pharmacy Technician
Provider Information
- NPI Number
1225757065- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2101 E SANTA FE ST, OLATHE, KS, 660621606
- Phone
- (913) 782-2323
Specialties & Taxonomies
Pharmacy Technician
Primary License: KS #14-100562
All Addresses
MAILING
1034 E COTTAGE CREEK CIR
GARDNER, KS, 660308406