Provider Demographics
NPI:1295080232
Name:NGUYEN, BI THANH (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:BI
Middle Name:THANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7547 MENTOR AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5438
Mailing Address - Country:US
Mailing Address - Phone:440-953-3950
Mailing Address - Fax:440-953-3953
Practice Address - Street 1:7547 MENTOR AVE
Practice Address - Street 2:STE 3
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5438
Practice Address - Country:US
Practice Address - Phone:440-953-3950
Practice Address - Fax:440-953-3953
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4289111N00000X
NYX012188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor