TIEN T PHAM

PEORIA, IL
NPI1912473273
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209017737)
Enumeration Date2018-10-15
Last Update Date2018-10-15
Business Address
TIEN T PHAM APN, CNP
5405 N KNOXVILLE AVE
PEORIA, IL 61614-5016
Phone number: 309-589-2050
Mailing Address
TIEN T PHAM APN, CNP
5405 N KNOXVILLE AVE
PEORIA, IL 61614-5016
Phone number: 309-589-2050