Provider Demographics
NPI:1104136019
Name:YAUN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:YAUN CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:YAUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-292-9328
Mailing Address - Street 1:65 ELLSWORTH ST APT 306
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-3166
Mailing Address - Country:US
Mailing Address - Phone:203-292-9328
Mailing Address - Fax:203-292-9330
Practice Address - Street 1:1735 POST RD BLDG 14
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5782
Practice Address - Country:US
Practice Address - Phone:203-292-9328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty