Individual
MS. TO UYEN T PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Mailing address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11146
MN
363AM0700X
Medical Physician Assistant
Primary
11146
MN
Other
Enumeration date
05/03/2012
Last updated
07/01/2024
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