Basic Information
| Provider Information | |||||||||
| NPI: | 1689074627 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | SINH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6001 SW 12TH ST APT 813 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731281876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053266912 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 724 24TH AVE NW STE 100 | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730696214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054471571 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2014 | ||||||||
| LastUpdateDate: | 08/27/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 4832 | OK | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.