Individual
PHUC LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5150 PINE HAVEN DR, COLORADO SPGS, CO 80923-5127
(719) 459-9985
Mailing address
5150 PINE HAVEN DR, COLORADO SPGS, CO 80923-5127
(719) 459-9985
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006604
CO
Other
Enumeration date
03/01/2020
Last updated
06/25/2024
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