Provider Demographics
NPI:1053489211
Name:NGUYEN, TUAN M (PT, OCS)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:M
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 EDGEFIELD RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-1938
Mailing Address - Country:US
Mailing Address - Phone:803-634-6983
Mailing Address - Fax:888-972-1745
Practice Address - Street 1:616 EDGEFIELD RD
Practice Address - Street 2:SUITE 150
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-1938
Practice Address - Country:US
Practice Address - Phone:803-634-6983
Practice Address - Fax:888-972-1745
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist