Individual
MR. TOMMY PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
201 N NORTHPARK LN, JOPLIN, MO 64801-8403
(417) 623-4313
Mailing address
3101 E 2ND PLZ, PANAMA CITY, FL 32401-5626
(850) 319-9596
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19030
FL
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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