Provider Demographics
NPI:1548378177
Name:LE, THU TAM (DC)
Entity type:Individual
Prefix:
First Name:THU
Middle Name:TAM
Last Name:LE
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 1:5002 CENTER ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3100
Mailing Address - Country:US
Mailing Address - Phone:402-827-8879
Mailing Address - Fax:
Practice Address - Street 1:5002 CENTER ST
Practice Address - Street 2:SUITE 4
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3100
Practice Address - Country:US
Practice Address - Phone:402-827-8879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1280111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor