Individual
DIEN KIM PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5640 RAND BLVD, SARASOTA, FL 34238-5174
(941) 917-4950
Mailing address
3842 WILLOW WALK DR, PALMETTO, FL 34221-9041
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25863
FL
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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