Provider Demographics
NPI:1417755612
Name:TRAN, TIN (DC)
Entity type:Individual
Prefix:DR
First Name:TIN
Middle Name:
Last Name:TRAN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 COUNTY ROAD B W STE 203
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2832
Mailing Address - Country:US
Mailing Address - Phone:651-313-5857
Mailing Address - Fax:
Practice Address - Street 1:1801 COUNTY ROAD B W STE 203
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-2832
Practice Address - Country:US
Practice Address - Phone:651-313-5857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor