MEDICARE: ANGELLIA YANG DC

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	57-58-12	WI

General Provider Information

NPI Number	:	1801515481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELLIA YANG DC

Provider Business Mailing Address
First Line	:	6645 N 113TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-5040
Country	:	US
Telephone Number	:	414-534-1903
Fax Number	:

Provider Business Practice Location Address
First Line	:	6645 N 113TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-5040
Country	:	US
Telephone Number	:	414-534-1903
Fax Number	:

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

Provider Enumeration Date	:	08/25/2022
Last Update Date	:	08/25/2022

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Directions to “ ANGELLIA YANG DC” Practice Location

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