Provider Demographics
NPI:1407626591
Name:VANG, VINAI (DC)
Entity Type:Individual
Prefix:DR
First Name:VINAI
Middle Name:
Last Name:VANG
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 1:12151 JUNIPER ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-2666
Mailing Address - Country:US
Mailing Address - Phone:651-242-6117
Mailing Address - Fax:
Practice Address - Street 1:12151 JUNIPER ST NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-2666
Practice Address - Country:US
Practice Address - Phone:651-242-6117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor