Keomanivong, Sid Christian

Keomanivong, Sid Christian is an individual health care provider with primary practice located at 2677 Beall Ln , Central Point OR 97502-1462. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as his primary health care specialty. Keomanivong, Sid Christian can be contacted via phone (702) 343-0466.

Contact Information

Primary practice address
2677 Beall Ln Central Point OR 97502-1462
Phone: (702) 343-0466
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 201806379NP-PP Oregon

Profile Details

NPI number 1760960462
LBN Legal business name Keomanivong, Sid Christian
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2018
Last updated Oct 8th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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