MEDICARE: DR. JERRY YEE-WEN LO D.C., M.S., B.S.

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	2659	TN

General Provider Information

NPI Number	:	1548500531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY YEE-WEN LO D.C., M.S., B.S.

Provider Business Mailing Address
First Line	:	2428 MELBOURNE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-1422
Country	:	US
Telephone Number	:	217-652-4568
Fax Number	:

Provider Business Practice Location Address
First Line	:	2428 MELBOURNE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-1422
Country	:	US
Telephone Number	:	217-652-4568
Fax Number	:

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

Provider Enumeration Date	:	02/27/2013
Last Update Date	:	09/09/2016

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