Healthcare Provider Details

I. General information

NPI: 1831245711
Provider Name (Legal Business Name): WILLIAM PERRY YAPP D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 IDLEWILD AVE
GREEN COVE SPRINGS FL
32043-3803
US

IV. Provider business mailing address

1212 IDLEWILD AVE
GREEN COVE SPRINGS FL
32043-3803
US

V. Phone/Fax

Practice location:
  • Phone: 904-284-4868
  • Fax: 904-284-8059
Mailing address:
  • Phone: 904-284-4868
  • Fax: 904-284-8059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH4844
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: