Sid Christian Keomanivong
NPI #1760960462 in Central Point, Oregon
Provider Information
- NPI Number
- 1760960462
- Entity Type
- Individual
- Name
- Sid Christian Keomanivong
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Primary Care
- Enumeration Date
- Aug 3, 2018
- Last Updated
- Oct 8, 2019
Practice Location
- Address
- 2677 BEALL LN
- City
- Central Point
- State
- Oregon
- ZIP Code
- 97502-1462
- Phone
- (702) 343-0466
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Primary Care — Primary Care |
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