Provider Demographics
NPI:1225436363
Name:NGUYEN, TRUONG QUANG (DC)
Entity Type:Individual
Prefix:
First Name:TRUONG
Middle Name:QUANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 PLEASANT HILL RD., SUITE 100
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:770-806-0644
Mailing Address - Fax:770-806-0678
Practice Address - Street 1:1533 PLEASANT HILL RD., SUITE 100
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:770-806-0644
Practice Address - Fax:770-806-0678
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor