Provider Demographics
NPI:1710157151
Name:NGUYEN, THOAI HONG (DC)
Entity Type:Individual
Prefix:
First Name:THOAI
Middle Name:HONG
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 1:310 N TENNESSEE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3270
Mailing Address - Country:US
Mailing Address - Phone:678-761-1848
Mailing Address - Fax:
Practice Address - Street 1:310 N TENNESSEE ST
Practice Address - Street 2:SUITE C
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3270
Practice Address - Country:US
Practice Address - Phone:678-761-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007813111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV05290Medicare UPIN
GA35ZCJFZMedicare PIN