Individual
ELY YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1408 S 36TH ST, MANITOWOC, WI 54220-5805
(920) 242-7608
Mailing address
1408 S 36TH ST, MANITOWOC, WI 54220-5805
(920) 242-7608
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3111-19
WI
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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