Provider Demographics
NPI:1538331566
Name:TUYET DINH
Entity Type:Organization
Organization Name:TUYET DINH
Other - Org Name:IASO CHIROPRACTIC, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUYET
Authorized Official - Middle Name:
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-567-7044
Mailing Address - Street 1:47 COLLINS STREET TER
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-2205
Mailing Address - Country:US
Mailing Address - Phone:508-567-7044
Mailing Address - Fax:617-965-4277
Practice Address - Street 1:957 WATERTOWN ST
Practice Address - Street 2:
Practice Address - City:WEST NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2125
Practice Address - Country:US
Practice Address - Phone:617-965-4276
Practice Address - Fax:617-965-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA92359OtherHARVARD PILGRIM
MA1265506281OtherNPI TYPE 1
MADI-Y45867OtherMEDICARE