Provider Demographics
NPI:1538689724
Name:YOHO, KEITH EMERSON (DC)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:EMERSON
Last Name:YOHO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 NELSON WAY
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-7874
Mailing Address - Country:US
Mailing Address - Phone:713-819-0828
Mailing Address - Fax:
Practice Address - Street 1:111 SE G ST STE D
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3011
Practice Address - Country:US
Practice Address - Phone:541-916-8350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor