Individual
MRS. TIFFANY PHUNG LY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 NIAGARA DR, SAN JOSE, CA 95130-1241
(415) 936-3169
Mailing address
1330 NIAGARA DR, SAN JOSE, CA 95130-1241
(415) 936-3169
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
81499
CA
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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