Provider Demographics
NPI:1124866124
Name:YANG, ANDY TENG
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:TENG
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 1:5275 EDINA INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2918
Mailing Address - Country:US
Mailing Address - Phone:769-270-9330
Mailing Address - Fax:
Practice Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 210
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2916
Practice Address - Country:US
Practice Address - Phone:763-270-9330
Practice Address - Fax:763-299-8621
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist