Provider Demographics
NPI:1760746846
Name:NGO, DUYEN (DC)
Entity Type:Individual
Prefix:
First Name:DUYEN
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4084 70TH TER N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-4610
Mailing Address - Country:US
Mailing Address - Phone:727-772-3310
Mailing Address - Fax:
Practice Address - Street 1:13119 66TH ST
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-1812
Practice Address - Country:US
Practice Address - Phone:727-519-0200
Practice Address - Fax:727-519-0086
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor