Provider Demographics
NPI:1942415187
Name:LUONG, LINH ANH (DC)
Entity type:Individual
Prefix:
First Name:LINH
Middle Name:ANH
Last Name:LUONG
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 1:6209 S 44TH DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-1961
Mailing Address - Country:US
Mailing Address - Phone:602-237-0391
Mailing Address - Fax:602-233-1199
Practice Address - Street 1:2726 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-5514
Practice Address - Country:US
Practice Address - Phone:602-233-1177
Practice Address - Fax:602-233-1199
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor