Provider Demographics
NPI:1144568502
Name:HERRERA, YOISLER SR (MD)
Entity type:Individual
Prefix:MR
First Name:YOISLER
Middle Name:
Last Name:HERRERA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PRAIRIE PKWY SW APT 53
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-2655
Mailing Address - Country:US
Mailing Address - Phone:786-398-0609
Mailing Address - Fax:
Practice Address - Street 1:2055 28TH ST SE STE 7
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-1582
Practice Address - Country:US
Practice Address - Phone:616-245-7013
Practice Address - Fax:616-245-7018
Is Sole Proprietor?:No
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 62516111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation