Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 0104556064 | VA |
NPI | 1306282470 |
---|---|
Provider Name | Thi Ngoc Nguyen |
First Address | Falls Church, VA 22044-2009 |
Second Address | Falls Church, VA 22044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2013 |
Last Update Date | 16/05/2013 |