Provider Demographics
NPI:1174897326
Name:CHA, YER TON (DC)
Entity type:Individual
Prefix:
First Name:YER
Middle Name:TON
Last Name:CHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1497 WHITE BEAR AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-2414
Mailing Address - Country:US
Mailing Address - Phone:651-605-5410
Mailing Address - Fax:651-776-2415
Practice Address - Street 1:1497 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-2414
Practice Address - Country:US
Practice Address - Phone:651-605-5410
Practice Address - Fax:651-776-2415
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32188111N00000X
MN5819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor