Healthcare Provider Details

I. General information

NPI: 1992046429
Provider Name (Legal Business Name): JOSEPH N YANKE CPO, LPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 MONROE ST NW
NEW PHILADELPHIA OH
44663-4139
US

IV. Provider business mailing address

1261 MONROE ST NW
NEW PHILADELPHIA OH
44663-4139
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-8343
  • Fax: 330-602-2547
Mailing address:
  • Phone: 330-343-8343
  • Fax: 330-602-2547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberLPO16
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberLPO16
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: