MEDICARE: ANGELA G YEAGER MS, PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05009762A	IN

General Provider Information

NPI Number	:	1326287608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA G YEAGER MS, PT

Provider Business Mailing Address
First Line	:	3813 S MADISON ST
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47302-5758
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1709 N WALNUT ST
Second Line	:
City	:	HARTFORD CITY
State	:	IN
Zip	:	47348-1359
Country	:	US
Telephone Number	:	765-348-4197
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	02/11/2009

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