Provider Demographics
NPI:1992264618
Name:TRAN, HAI HOANG (ATC)
Entity type:Individual
Prefix:
First Name:HAI
Middle Name:HOANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:207 MAIN ST NW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5023
Mailing Address - Country:US
Mailing Address - Phone:678-462-2550
Mailing Address - Fax:
Practice Address - Street 1:207 MAIN ST NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-5023
Practice Address - Country:US
Practice Address - Phone:678-462-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer