Provider Demographics
NPI:1245404607
Name:YU, KIL-YOUNG (DACM)
Entity Type:Individual
Prefix:DR
First Name:KIL-YOUNG
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:DACM
Other - Prefix:DR
Other - First Name:KY
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:116 LOCUST AVE STE F
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3515
Mailing Address - Country:US
Mailing Address - Phone:931-400-0880
Mailing Address - Fax:855-628-4958
Practice Address - Street 1:116 LOCUST AVE STE F
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3515
Practice Address - Country:US
Practice Address - Phone:931-400-0880
Practice Address - Fax:855-628-4958
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11554171100000X
TN377171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist