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General NPI Number Information
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NPI Number | 1346504388
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Entity Type | Individual
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Provider Name | LE NGUYEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 09/20/2014
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Provider Practice Location Address
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Address Line | 3703 W DOUGLAS AVE
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City | WICHITA
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State | KS
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Zip | 67213-2407
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Country | US
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Telephone | 316-990-1486
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E MCARTOR ST LOT 91
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City | DODGE CITY
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State | KS
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Zip | 67801-6614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01-05487
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License Number State | KS
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