Provider Demographics
NPI:1588988174
Name:VU, TUONG-QUYNH THUY (DC)
Entity type:Individual
Prefix:
First Name:TUONG-QUYNH
Middle Name:THUY
Last Name:VU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 VICKY DR SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49418-8720
Mailing Address - Country:US
Mailing Address - Phone:616-633-5696
Mailing Address - Fax:
Practice Address - Street 1:2950 VICKY DR SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49418-8720
Practice Address - Country:US
Practice Address - Phone:616-633-5696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1588988174Medicaid