Individual
MR. PHONG T PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
868 SWAPS DR, SHAKOPEE, MN 55379-3801
(612) 940-5907
Mailing address
868 SWAPS DRIVE, SHAKOPEE, MN 55379
(612) 940-5907
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116529
MN
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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