Individual
PHONG THANH TRUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7015 PARK AVE, HOUMA, LA 70364-2850
(985) 879-2407
Mailing address
7015 PARK AVE, HOUMA, LA 70364-2850
(858) 792-4079
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020296
LA
Other
Enumeration date
09/02/2013
Last updated
06/17/2022
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