Provider Demographics
NPI:1720370273
Name:TUAN C TRUONG DC PC
Entity Type:Organization
Organization Name:TUAN C TRUONG DC PC
Other - Org Name:NEWNAN FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-683-9105
Mailing Address - Street 1:197 JEFFERSON PKWY
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-5823
Mailing Address - Country:US
Mailing Address - Phone:770-683-9105
Mailing Address - Fax:770-683-9107
Practice Address - Street 1:197 JEFFERSON PKWY
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5823
Practice Address - Country:US
Practice Address - Phone:770-683-9105
Practice Address - Fax:770-683-9107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO06841305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service