Provider Demographics
NPI:1750043147
Name:YANG, LEE HOUA
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:HOUA
Last Name:YANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 NEW JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-4843
Mailing Address - Country:US
Mailing Address - Phone:920-946-7058
Mailing Address - Fax:
Practice Address - Street 1:1426 NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-4843
Practice Address - Country:US
Practice Address - Phone:920-946-7058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker