Individual
PHONG LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 240-5549
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
01/13/2023
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