Provider Demographics
NPI:1265683924
Name:YAMAMOTO, YUKO (DC, LAC)
Entity Type:Individual
Prefix:
First Name:YUKO
Middle Name:
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 WESTINGHOUSE RD STE 1160
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7645
Mailing Address - Country:US
Mailing Address - Phone:512-200-7222
Mailing Address - Fax:
Practice Address - Street 1:1821 WESTINGHOUSE RD STE 1160
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7645
Practice Address - Country:US
Practice Address - Phone:512-200-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30759111N00000X
CAAC12500171100000X
TX11636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist