Provider Demographics
NPI:1609117076
Name:NGUYEN, NGOC T (DPT)
Entity Type:Individual
Prefix:MISS
First Name:NGOC
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:5406 E 120TH PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3287
Mailing Address - Country:US
Mailing Address - Phone:720-737-4643
Mailing Address - Fax:
Practice Address - Street 1:400 INDIANA ST
Practice Address - Street 2:SUITE 320
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5027
Practice Address - Country:US
Practice Address - Phone:720-358-4607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0011825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist