Bounyaveth Phachomphon
NPI #1477413011 in South Sioux City, Nebraska
Provider Information
- NPI Number
- 1477413011
- Entity Type
- Individual
- Name
- Bounyaveth Phachomphon
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Chore Provider
- Enumeration Date
- Nov 17, 2025
- Last Updated
- Nov 17, 2025
Practice Location
- Address
- 320 BROADMOOR DR
- City
- South Sioux City
- State
- Nebraska
- ZIP Code
- 68776-3806
- Phone
- (402) 508-0009
Specialties & Taxonomy Codes
| Specialty |
|---|
| Chore Provider |
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