Healthcare Provider Details

I. General information

NPI: 1376657700
Provider Name (Legal Business Name): ANNE WOOD YEARICK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13898 ROUTE 30
NORTH HUNTINGDON PA
15642-2133
US

IV. Provider business mailing address

2035 HAMPSTEAD DR
PITTSBURGH PA
15235-5038
US

V. Phone/Fax

Practice location:
  • Phone: 724-861-6001
  • Fax: 724-861-9155
Mailing address:
  • Phone: 412-244-0510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberDAPT000660
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: