Healthcare Provider Details

I. General information

NPI: 1477013340
Provider Name (Legal Business Name): CHARLES YAHR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5889 FORBES AVE STE 100
PITTSBURGH PA
15217-1660
US

IV. Provider business mailing address

6357 MONITOR ST
PITTSBURGH PA
15217-2719
US

V. Phone/Fax

Practice location:
  • Phone: 412-422-4490
  • Fax:
Mailing address:
  • Phone: 412-849-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3639L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: