KELLY LORAINE DAUER PHAM

VIENNA, VA
NPI1417274689
Former NameKELLY LORAINE DAUER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine
(Licence: VA  0101273373)
Additional Taxonomies208100000X Physical Medicine & Rehabilitation
(Licence: VA  0101273373)
208100000X Physical Medicine & Rehabilitation
(Licence: DC  185401)
2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine
(Licence: WA  FE60464961)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2010-04-28
Last Update Date2022-04-13
Business Address
KELLY LORAINE DAUER PHAM MD
8230 BOONE BLVD STE 170
VIENNA, VA 22182-2621
Phone number: 571-310-2502
Mailing Address
KELLY LORAINE DAUER PHAM MD
8230 BOONE BLVD STE 170
VIENNA, VA 22182-2621
Phone number: 571-310-2502
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