Healthcare Provider Details

I. General information

NPI: 1730851544
Provider Name (Legal Business Name): RACHEL MAE YEARY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 OLD GALLATIN RD
SCOTTSVILLE KY
42164-8666
US

IV. Provider business mailing address

352 OLD GALLATIN RD
SCOTTSVILLE KY
42164-8666
US

V. Phone/Fax

Practice location:
  • Phone: 270-237-3304
  • Fax:
Mailing address:
  • Phone: 270-237-3304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number273300
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: