Lisa Pham, OD

NPI #1144881491 in Fort Wayne, Indiana

Provider Information

NPI Number: 1144881491
Entity Type: Individual
Name: Lisa Pham, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jun 27, 2019
Last Updated: Dec 30, 2020

Practice Location

Address: 3905 N ANTHONY BLVD
City: Fort Wayne
State: Indiana
ZIP Code: 46805-2233
Phone: (260) 432-8409

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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