Healthcare Provider Details

I. General information

NPI: 1144628561
Provider Name (Legal Business Name): YEN CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 N DECATUR BLVD STE 116
LAS VEGAS NV
89130-3267
US

IV. Provider business mailing address

3231 N DECATUR BLVD STE 116
LAS VEGAS NV
89130-3267
US

V. Phone/Fax

Practice location:
  • Phone: 702-685-8776
  • Fax: 877-699-1370
Mailing address:
  • Phone: 702-685-8776
  • Fax: 877-699-1370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01459
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DANIEL D YEN
Title or Position: MANAGER
Credential: DC
Phone: 626-410-8523