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1174296461
PHANTA JAH
FALLS CHURCH, VA
NPI
1174296461
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: VA 0024182355)
Enumeration Date
2021-08-01
Last Update Date
2022-08-01
Business Address
PHANTA JAH
2833 CLEAVE DR.
FALLS CHURCH, VA 22042
Phone number: 800-969-1104
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Mailing Address
PHANTA JAH
2833 CLEAVE DR.
FALLS CHURCH, VA 22042-1837
Phone number: 180-096-9110
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