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Individual

KIM OANH PHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
3248 LITHIA PINECREST RD STE 102, VALRICO, FL 33596-5682
(813) 622-1366
Mailing address
16103 STAGS LEAP DR, LUTZ, FL 33559-2003
(813) 325-9562

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 26602
FL

Other

Enumeration date
04/19/2016
Last updated
04/19/2016
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