Provider Demographics
NPI:1992756993
Name:TRAN, PAUL S (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-6197
Mailing Address - Country:US
Mailing Address - Phone:502-867-7478
Mailing Address - Fax:502-867-7428
Practice Address - Street 1:205 CHAMPION WAY
Practice Address - Street 2:SUITE #8
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8862
Practice Address - Country:US
Practice Address - Phone:502-867-7478
Practice Address - Fax:502-867-7428
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10314111N00000X
KY5029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor