Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 3524 | MA |
Y | 111N00000X | Chiropractor | 38MC00759700 | NJ |
NPI | 1003268376 |
---|---|
Provider Name | Jeongho Yoo |
First Address | Plainsboro, NJ 08536-3046 |
Second Address | Plainsboro, NJ 08536-3046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 17/02/2019 |