LY T PHAN

COLUMBIA, MO
NPI1356430870
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: MO  2005030724)
Enumeration Date2006-10-12
Last Update Date2017-04-11
Business Address
-- LY T PHAN MD
1601 E BROADWAY STE 240
COLUMBIA, MO 65201-8020
Phone number: 573-815-8145
Mailing Address
-- LY T PHAN MD
670 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 63141-8573
Phone number: 573-815-8145
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