Individual
LUU PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14285 W GRAND AVE, SURPRISE, AZ 85374-4297
(623) 975-3944
Mailing address
555 N COLLEGE AVE APT 2011, TEMPE, AZ 85281-0187
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S022830
AZ
Other
Enumeration date
11/04/2017
Last updated
11/04/2017
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