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Individual
TRUNG TIN PHAN
Active
Individual
TRUNG TIN PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015913
GA
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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