Most Relevant Information
Provider Data
| NPI Number: | 1003342981 |
| Provider Name: | VI T PHAM PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | PA.0004927 |
Most Important Dates
| Enumeration Date: | 05/11/2017 |
| Last Updated: | 05/11/2017 |
Provider Practice Location
1080 CHINOOK LN
PUEBLO
CO
810011850
Practice Location Phone/Fax
| Phone: | 7195649400 |
| Fax: | 7195640497 |
Provider Mailing Location
1080 CHINOOK LN
PUEBLO
CO
810011850
Provider Mailing Phone/Fax
| Phone: | 7195649400 |
| Fax: | 7195640497 |