Individual
DR. TAN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3320 BUFORD DR STE 60, BUFORD, GA 30519-8703
(770) 614-1009
Mailing address
3320 BUFORD DR STE 60, BUFORD, GA 30519-8703
(770) 614-1009
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010594
GA
Other
Enumeration date
06/12/2022
Last updated
06/12/2022
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