Provider Demographics
NPI:1073704110
Name:YAUCKOES, ROBERT VINCENT (LICAC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:VINCENT
Last Name:YAUCKOES
Suffix:
Gender:M
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-2953
Mailing Address - Country:US
Mailing Address - Phone:508-405-2881
Mailing Address - Fax:
Practice Address - Street 1:665 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-2953
Practice Address - Country:US
Practice Address - Phone:508-405-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAC226525171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist