Individual
PHAN QUACH DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPH
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 456-5473
(405) 456-1716
Mailing address
2908 TWIN LAKE DR, OKLAHOMA CITY, OK 73165-7351
(405) 456-3705
(405) 456-1716
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11868
OK
Other
Enumeration date
09/15/2008
Last updated
09/15/2008
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