Provider Demographics
NPI:1538992508
Name:TRAN, PHUONG (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 N PROSPECTOR LN
Mailing Address - Street 2:
Mailing Address - City:ENOCH
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9405
Mailing Address - Country:US
Mailing Address - Phone:510-894-9723
Mailing Address - Fax:
Practice Address - Street 1:1333 N MAIN ST # 6
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9314
Practice Address - Country:US
Practice Address - Phone:435-868-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14119656-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist