Khampasong Haleudeth
Khampasong Haleudeth is a Physical Therapist in Medford, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2021.
- Licensed in
- MA
- In the registry since
- 2021
Practice location Address checks out
275 Mystic Ave Ste CMedford, MA 02155-6301
Phone: (781) 874-9294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapist (primary) | Taxonomy 225100000X · Licence 25676 (MA) |
|---|
Record details
| NPI number | 1992475081 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 20, 2021 |
| Last updated in NPPES | September 20, 2021 |
| Certification date | September 20, 2021 |
| Mailing address | 275 Mystic Ave Ste C, Medford, MA 02155-6301 |
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