Provider Demographics
NPI:1306907076
Name:YANG, CHARLES THEUS (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:THEUS
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 1:4933 TUSCARAWAS ST W
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-5011
Mailing Address - Country:US
Mailing Address - Phone:330-477-3036
Mailing Address - Fax:330-477-3037
Practice Address - Street 1:4933 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5011
Practice Address - Country:US
Practice Address - Phone:330-477-3036
Practice Address - Fax:330-477-3037
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor