MEDICARE: DR. HIEU KIM TRINH 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	5680	MN

General Provider Information

NPI Number	:	1518228949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HIEU KIM TRINH D.C.

Provider Business Mailing Address
First Line	:	2421 7TH ST W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2839
Country	:	US
Telephone Number	:	651-699-1222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2421 7TH ST W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-2839
Country	:	US
Telephone Number	:	651-699-1222
Fax Number	:

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

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	06/15/2012

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