Individual
VIET Q VO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
90 MORGAN ST STE 103, STAMFORD, CT 06905-5436
(203) 978-3138
(203) 325-3270
Mailing address
56 BALIS ST, SPRINGFIELD, MA 01109-2506
(413) 356-0023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1.076102-DO
CT
208D00000X
General Practice Physician
20835001
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
07/26/2024
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