Provider Demographics
NPI:1255082897
Name:VINLUAN, SUYENNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:SUYENNE
Middle Name:
Last Name:VINLUAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 BRYSON WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5806
Mailing Address - Country:US
Mailing Address - Phone:541-816-5965
Mailing Address - Fax:
Practice Address - Street 1:724 S CENTRAL AVE # C1202NE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7851
Practice Address - Country:US
Practice Address - Phone:541-507-9902
Practice Address - Fax:541-507-9986
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist