NPI 1063044147

Sal Senethavisuok

Practitioner Contractor Columbus, OH

Practice location

Address: 4235 Aruba Dr, Columbus, OH 43230-5116
Phone: (614) 316-2777

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 33021667 (OH)

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Registry record

NPI: 1063044147
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Feb 2020
Record last updated: 6 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.