Phan Tasco Anderson PA

NPI 1265570105 - Physician Assistant - 363A00000X

NPI Details
NPI 1265570105
Gender Female
Enumeration Date 02/02/2007
Last Updated 01/18/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
203 GREYTHORNE DR
KATHLEEN GA, 31047-5304, US
Phone (719) 337-9392
Fax
Business Location
203 GREYTHORNE DR
KATHLEEN GA, 31047-5304, US
Phone (719) 337-9392
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Colorado
License Number 1457
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According to our database, Phan Tasco Anderson PA NPI is 1265570105, taxonomy code is 363A00000X and license number is 1457, license state is located at Colorado. Phan Tasco Anderson PA physically located at 203 Greythorne Dr, Kathleen GA, 31047-5304. NPI Number Phan Tasco Anderson PA has the Individual type.

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1265570105 NPI number is provided on an as is basis without warranty of any kind. 1265570105 is maintained by the National Plan & Provider Enumeration System. The contents of Phan Tasco Anderson PA are for informational purposes only.