MEDICARE: HUY KIEN VO P.T.

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	225100000X	Physical Therapist	292354	CA

General Provider Information

NPI Number	:	1942743174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUY KIEN VO P.T.

Provider Business Mailing Address
First Line	:	14381 LYNDON ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4636
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14381 LYNDON ST
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92843-4636
Country	:	US
Telephone Number	:	714-876-4323
Fax Number	:

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

Provider Enumeration Date	:	11/19/2016
Last Update Date	:	11/19/2016

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