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1144881491
LISA PHAM
FORT WAYNE, IN
NPI
1144881491
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: IN 18004252A)
Enumeration Date
2019-06-27
Last Update Date
2020-12-30
Business Address
LISA PHAM OD
3905 N ANTHONY BLVD
FORT WAYNE, IN 46805-2233
Phone number: 260-432-8409
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Mailing Address
LISA PHAM OD
1530 SPENSER CV
FORT WAYNE, IN 46845-2365
Phone number: 260-579-2014
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