Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | MA 62516 | FL |
NPI | 1144568502 |
---|---|
Provider Name | Mr. Yoisler Herrera SR. |
First Address | Wyoming, MI 49519-2655 |
Second Address | Grand Rapids, MI 49508-1582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2013 |
Last Update Date | 19/01/2013 |