KHOA PHAM

APO, AP
NPI1740865765
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence:   1178809)
Enumeration Date2021-03-11
Last Update Date2025-10-13
Business Address
KHOA PHAM PA-C
UNIT 15092
APO, AP 96224-5092
Phone number: 315-737-3543
Mailing Address
KHOA PHAM PA-C
111050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602
Phone number: 714-855-7979
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