Individual
GLORIA TRAM PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4641 ROSWELL RD, ATLANTA, GA 30342-3073
(404) 474-0506
(404) 474-0515
Mailing address
192 WINDSONG LN SW, LILBURN, GA 30047-3949
(678) 524-8416
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007021
GA
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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