Individual
PANG KOU PHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 PHILADELPHIA AVE, SHILLINGTON, PA 19607-2731
(610) 796-1600
Mailing address
31 HOMESTEAD DR, DENVER, PA 17517-9173
(717) 847-1161
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP008479
PA
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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