Provider Demographics
NPI:1356771497
Name:DAVIS, YIRAN WANG
Entity type:Individual
Prefix:MRS
First Name:YIRAN
Middle Name:WANG
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2894 AUTUMN APPLAUSE DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8395
Mailing Address - Country:US
Mailing Address - Phone:614-403-9595
Mailing Address - Fax:
Practice Address - Street 1:2894 AUTUMN APPLAUSE DR
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8395
Practice Address - Country:US
Practice Address - Phone:614-403-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist