MEDICARE: DR. YONG H JUNG DC MS

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	111N00000X	Chiropractor	B00880	NV

General Provider Information

NPI Number	:	1457452716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YONG H JUNG DC MS

Provider Business Mailing Address
First Line	:	505 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3910
Country	:	US
Telephone Number	:	702-870-7582
Fax Number	:	702-870-7583

Provider Business Practice Location Address
First Line	:	505 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3910
Country	:	US
Telephone Number	:	702-870-7582
Fax Number	:	702-870-7583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	04/15/2008

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