Individual
LUAN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
585 NUT TREE CT, VACAVILLE, CA 95687-3353
(408) 624-7910
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50867
CA
Other
Enumeration date
12/19/2020
Last updated
12/19/2020
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