Thammavongsa, Jack
Thammavongsa, Jack is an individual health care provider with primary practice located at 3D Med Bn, 3D Mlg H&S Co Unit #38447, Fpo AP 96604-8447. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Thammavongsa, Jack can be contacted via phone (315) 623-4960.Contact Information
Primary practice address
3D Med Bn, 3D Mlg H&S Co Unit #38447
Fpo AP 96604-8447
Phone: (315) 623-4960
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1174848683 |
|---|---|
| LBN Legal business name | Thammavongsa, Jack |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2010 |
| Last updated | Mar 29th, 2010 - about 14 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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