Provider Demographics
NPI:1841968278
Name:YUH, ISAAC YOUNGWOO (PT)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:YOUNGWOO
Last Name:YUH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7114
Mailing Address - Country:US
Mailing Address - Phone:541-776-2495
Mailing Address - Fax:
Practice Address - Street 1:36 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7114
Practice Address - Country:US
Practice Address - Phone:541-776-2495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist