Provider Demographics
NPI:1447513775
Name:DANG, THY THANH (DC)
Entity type:Individual
Prefix:DR
First Name:THY
Middle Name:THANH
Last Name:DANG
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 1:1501 BROOKWOOD AVE RM A
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1358
Mailing Address - Country:US
Mailing Address - Phone:580-252-1064
Mailing Address - Fax:580-252-1253
Practice Address - Street 1:1501 BROOKWOOD AVE RM A
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1358
Practice Address - Country:US
Practice Address - Phone:580-252-1064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor