Healthcare Provider Details

I. General information

NPI: 1720173495
Provider Name (Legal Business Name): JOHN DEAN YERKEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 BEV ROAD
BOARDMAN OH
44512
US

IV. Provider business mailing address

824 BEV ROAD
BOARDMAN OH
44512
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-1100
  • Fax: 330-729-1101
Mailing address:
  • Phone: 330-729-1100
  • Fax: 330-729-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number3228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: