Individual
LORENZO TIEN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC
Contact information
Practice address
725 W GRANADA BLVD UNIT 17, ORMOND BEACH, FL 32174-5107
(386) 255-6953
Mailing address
946 15TH ST APT 202, HOLLY HILL, FL 32117-2076
(386) 212-9131
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00803
TX
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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