Provider Demographics
NPI:1467703264
Name:TRAN, ZON VAN (PT)
Entity Type:Individual
Prefix:MR
First Name:ZON
Middle Name:VAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W LANTANA CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2848
Mailing Address - Country:US
Mailing Address - Phone:605-929-3203
Mailing Address - Fax:
Practice Address - Street 1:412 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6901
Practice Address - Country:US
Practice Address - Phone:605-336-1188
Practice Address - Fax:605-336-2677
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0651225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist