Provider Demographics
NPI:1912765603
Name:YANG, MAISEE N (RDMS,RVT)
Entity type:Individual
Prefix:
First Name:MAISEE
Middle Name:N
Last Name:YANG
Suffix:
Gender:F
Credentials:RDMS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8225 MARSH POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7432
Mailing Address - Country:US
Mailing Address - Phone:763-777-2870
Mailing Address - Fax:
Practice Address - Street 1:1425 I85 PKWY STE G
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2860
Practice Address - Country:US
Practice Address - Phone:334-455-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2816802471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography