Individual
MR. TONG THANH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
8495 CRATER LAKE HWY STOP 117B209, WHITE CITY, OR 97503-3011
(561) 826-2111
Mailing address
157 S KEENE WAY DR, MEDFORD, OR 97504-7509
(619) 726-5049
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CP004537
CA
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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