Provider Demographics
NPI:1124594403
Name:TRIEU FOOT SOLUTIONS LLC
Entity Type:Organization
Organization Name:TRIEU FOOT SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRIEU
Authorized Official - Middle Name:
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:425-274-6027
Mailing Address - Street 1:609 5TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-2216
Mailing Address - Country:US
Mailing Address - Phone:386-219-0171
Mailing Address - Fax:386-219-0191
Practice Address - Street 1:609 5TH ST SW
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-2216
Practice Address - Country:US
Practice Address - Phone:425-274-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty