Provider Demographics
NPI:1023192143
Name:YOHE, KENT G (DOCTOR OF CHIROPRACT)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:G
Last Name:YOHE
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2800 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6030
Practice Address - Country:US
Practice Address - Phone:701-237-0614
Practice Address - Fax:701-237-0615
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND343111N00000X
AZ3364R111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12105Medicaid
ND346727900Medicaid
ND12105Medicaid
ND346727900Medicaid