Healthcare Provider Details

I. General information

NPI: 1275697674
Provider Name (Legal Business Name): HOOKER-YASKO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4735 NORREL DR SUITE 5
TRUSSVILLE AL
35173-3603
US

IV. Provider business mailing address

4735 NORREL DR SUITE 5
TRUSSVILLE AL
35173-3603
US

V. Phone/Fax

Practice location:
  • Phone: 205-655-0123
  • Fax: 205-655-0466
Mailing address:
  • Phone: 205-655-0123
  • Fax: 205-655-0466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1869
License Number StateAL

VIII. Authorized Official

Name: DR. DIRK YASKO
Title or Position: PHYSICIAN
Credential: DC
Phone: 205-655-0123