Individual
TINA PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7625 S 3200 W STE 2, WEST JORDAN, UT 84084-2887
(801) 915-0359
Mailing address
11190 S 465 E, SANDY, UT 84070-5360
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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