MEDICARE: DR. CUONG VAN NGUYEN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	10716	TX
2	111N00000X	Chiropractor	038-010443	IL
3	111N00000X	Chiropractor	DC4233	OH

General Provider Information

NPI Number	:	1366486177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CUONG VAN NGUYEN D.C.

Provider Business Mailing Address
First Line	:	1108 KEMPER MEADOW DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-4117
Country	:	US
Telephone Number	:	513-620-8191
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 KEMPER MEADOW DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-4117
Country	:	US
Telephone Number	:	513-620-8194
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	06/06/2013

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