Provider Demographics
NPI:1669811097
Name:TRAN, KIM CHRISTIN (DC)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:CHRISTIN
Last Name:TRAN
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 1:1300 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2684
Mailing Address - Country:US
Mailing Address - Phone:612-868-8617
Mailing Address - Fax:
Practice Address - Street 1:7610 LYNDALE AVE S STE 600
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-4167
Practice Address - Country:US
Practice Address - Phone:919-986-8183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350005335Medicare PIN