Provider Demographics
NPI:1902342223
Name:XIONG, YER T
Entity Type:Individual
Prefix:
First Name:YER
Middle Name:T
Last Name:XIONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 ARCADE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-2080
Mailing Address - Country:US
Mailing Address - Phone:651-778-3013
Mailing Address - Fax:651-778-3014
Practice Address - Street 1:705 3RD ST E
Practice Address - Street 2:ST PAUL
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-5103
Practice Address - Country:US
Practice Address - Phone:651-278-7078
Practice Address - Fax:651-778-3014
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor