MEDICARE: YEN CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor
2	111N00000X	Chiropractor	B01459	NV

General Provider Information

NPI Number	:	1144628561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YEN CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	3231 N DECATUR BLVD STE 116
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3267
Country	:	US
Telephone Number	:	702-685-8776
Fax Number	:	877-699-1370

Provider Business Practice Location Address
First Line	:	3231 N DECATUR BLVD STE 116
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3267
Country	:	US
Telephone Number	:	702-685-8776
Fax Number	:	877-699-1370

Authorized Official
Title or Position	:	MANAGER
Name	:	DANIEL D YEN
Credential	:	DC
Telephone Number	:	626-410-8523

Provider Enumeration Date	:	12/17/2014
Last Update Date	:	12/16/2021

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Directions to “YEN CHIROPRACTIC LLC ” Practice Location

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