Healthcare Provider Details

I. General information

NPI: 1154233104
Provider Name (Legal Business Name): DUKE D NGUYEN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6341 E SOUTHERN AVE STE 108
MESA AZ
85206-3713
US

IV. Provider business mailing address

PO BOX 5718
KALISPELL MT
59903-5718
US

V. Phone/Fax

Practice location:
  • Phone: 480-354-2911
  • Fax: 480-984-3169
Mailing address:
  • Phone: 406-756-0134
  • Fax: 406-309-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-034909
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: