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General NPI Number Information
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NPI Number | 1902178387
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Entity Type | Organization
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Legal Business Name | TERESA YIN WONG CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 39210 STATE ST SUITE 110
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City | FREMONT
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State | CA
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Zip | 94538-1456
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Country | US
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Telephone | 510-793-6302
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Fax | 510-793-6305
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Provider Business Mailing Address
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Address Line | 39210 STATE ST SUITE 110
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City | FREMONT
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State | CA
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Zip | 94538-1456
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Country | US
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Telephone | 510-793-6302
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Fax | 510-793-6305
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TERESA YIN WONG
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Credential | D,C,
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Telephone | 510-793-6302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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