Individual
PHUC PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1229 N EASTERN AVE, MOORE, OK 73160-5860
(405) 793-1120
Mailing address
1229 N EASTERN AVE, MOORE, OK 73160-5860
(405) 793-1120
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14810
OK
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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