MR. Tai Keawphalouk

NPI #1093209116 in Shawnee, Oklahoma

Provider Information

NPI Number: 1093209116
Entity Type: Individual
Name: MR. Tai Keawphalouk
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Jun 21, 2018
Last Updated: Jun 21, 2018

Practice Location

Address: 1010 E 45TH ST
City: Shawnee
State: Oklahoma
ZIP Code: 74804-2202
Phone: (405) 273-7493

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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