KY VIET PHAN

BATON ROUGE, LA
NPI1013146661
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: LA  A3976)
Enumeration Date2009-07-03
Last Update Date2009-07-03
Business Address
-- KY VIET PHAN PTA
5432 SPRINGWATER DR
BATON ROUGE, LA 70817-2457
Phone number: 228-238-9200
Mailing Address
-- KY VIET PHAN PTA
5432 SPRINGWATER DR
BATON ROUGE, LA 70817-2457
Phone number: 228-238-9200
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