Healthcare Provider Details

I. General information

NPI: 1003045451
Provider Name (Legal Business Name): CHAE EUN YEO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WILLIAMSBURG PL SUITE 250
WARRENDALE PA
15086-7540
US

IV. Provider business mailing address

1 WILLIAMSBURG PL SUITE 250
WARRENDALE PA
15086-7540
US

V. Phone/Fax

Practice location:
  • Phone: 724-933-3223
  • Fax: 724-933-3470
Mailing address:
  • Phone: 724-933-3223
  • Fax: 724-933-3470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC009815
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: