Search › Minnesota › 125J00000X
Phonsuda Chanthavisouk, RDH, MDT
NPI 1548844053 · on the registry since 2021
Practice
- Address
- 728 E Hennepin Ave
Minneapolis, MN 55414 - Phone
- (612) 746-1530
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 125J00000X
125J00000X
- Also registered as
- 124Q00000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-08-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota