Healthcare Provider Details

I. General information

NPI: 1841875572
Provider Name (Legal Business Name): YODER PHYSICAL THERAPY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905B PONDER AVE
SARASOTA FL
34232-6632
US

IV. Provider business mailing address

905B PONDER AVE
SARASOTA FL
34232-6632
US

V. Phone/Fax

Practice location:
  • Phone: 941-227-4855
  • Fax:
Mailing address:
  • Phone: 941-227-4855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENT YODER
Title or Position: CO-OWNER/ PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 941-227-4855