Healthcare Provider Details

I. General information

NPI: 1225622848
Provider Name (Legal Business Name): AIMEE O YERVASI DC, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 OLD CANTON RD APT C
BALL GROUND GA
30107-2943
US

IV. Provider business mailing address

195 PLEASANT HILL RD
JASPER GA
30143-3029
US

V. Phone/Fax

Practice location:
  • Phone: 770-275-3320
  • Fax:
Mailing address:
  • Phone: 770-275-3320
  • Fax: 770-275-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT002760
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR010481
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: