Provider Demographics
NPI:1821364787
Name:YUEN, ELSIE GRACE (DC)
Entity Type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:GRACE
Last Name:YUEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 STROUPS HICKOX RD
Mailing Address - Street 2:
Mailing Address - City:WEST FARMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44491-8709
Mailing Address - Country:US
Mailing Address - Phone:330-989-8099
Mailing Address - Fax:330-989-8099
Practice Address - Street 1:4790 STROUPS HICKOX RD
Practice Address - Street 2:
Practice Address - City:WEST FARMINGTON
Practice Address - State:OH
Practice Address - Zip Code:44491-8709
Practice Address - Country:US
Practice Address - Phone:330-989-8099
Practice Address - Fax:330-989-8099
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32236111N00000X
OH4119111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor