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General NPI Number Information
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NPI Number | 1083753206
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Entity Type | Individual
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Provider Name | SANG YOUL YOUM
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6 MONTGOMERY VILLAGE AVE STE 401
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City | GAITHERSBURG
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State | MD
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Zip | 20879-3548
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Country | US
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Telephone | 301-987-0424
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Fax | 301-987-9339
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Provider Business Mailing Address
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Address Line | 306 PRETTYMAN DR APT 8306
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City | ROCKVILLE
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State | MD
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Zip | 20850-7707
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Country | US
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Telephone | 301-326-6299
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Fax | 301-987-9339
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 03417
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License Number State | MD
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