Provider Demographics
NPI:1013222868
Name:TRUONG, VAN (VON) (L AC)
Entity Type:Individual
Prefix:
First Name:VAN (VON)
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7655 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1414
Mailing Address - Country:US
Mailing Address - Phone:303-235-8778
Mailing Address - Fax:
Practice Address - Street 1:7655 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1414
Practice Address - Country:US
Practice Address - Phone:303-235-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO179171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist