Provider Demographics
NPI:1063728467
Name:YANG, PLER (DC)
Entity type:Individual
Prefix:DR
First Name:PLER
Middle Name:
Last Name:YANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 SCHELFHOUT LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KIMBERLY
Mailing Address - State:WI
Mailing Address - Zip Code:54136-2063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:819 SCHELFHOUT LN
Practice Address - Street 2:SUITE 105
Practice Address - City:KIMBERLY
Practice Address - State:WI
Practice Address - Zip Code:54136-2063
Practice Address - Country:US
Practice Address - Phone:920-883-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4629-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor