Healthcare Provider Details

I. General information

NPI: 1073706891
Provider Name (Legal Business Name): JOSEPH NORMAN YEARWOOD III P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 NEW HAMPSHIRE AVE SUITE 420-430
HYATTSVILLE MD
20783-3269
US

IV. Provider business mailing address

6475 NEW HAMPSHIRE AVE. SUITE 420-430
HYATTSVILLE MD
20783-3269
US

V. Phone/Fax

Practice location:
  • Phone: 301-270-2525
  • Fax: 301-270-2526
Mailing address:
  • Phone: 301-270-2525
  • Fax: 301-270-2526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14547
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: