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NPI Code Detail

MEDICARE: BINH PHAN PTA

MEDICARE:   BINH  PHAN  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant0013147CO

General Provider Information

NPI Number : 1861815219
Entity Type Code : Individual
Provider Name (Legal Business Name) : BINH PHAN PTA
Provider Business Mailing Address
First Line : 6868 S IVY ST APT 108
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-6264
Country : US
Telephone Number : 714-642-7363
Fax Number :
Provider Business Practice Location Address
First Line : 6868 S IVY ST APT 108
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-6264
Country : US
Telephone Number : 714-642-7363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2014
Last Update Date : 01/21/2014

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Directions to “ BINH PHAN PTA” Practice Location

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