Individual
PHONG DUONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 NW 12TH ST, MOORE, OK 73170-1220
(405) 799-2244
Mailing address
812 NW 18TH ST, MOORE, OK 73160-1508
(405) 512-9263
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14792
OK
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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