Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 25MZ00061500 | NJ |
NPI | 1154615748 |
---|---|
Provider Name | Ms. Jennifer Lynn Yanko |
First Address | Atlantic Highlands, NJ 07716-1286 |
Second Address | Atlantic Highlands, NJ 07716-1286 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 01/06/2011 |