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General NPI Number Information
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NPI Number | 1093497844
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Entity Type | Organization
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Legal Business Name | YANCI JO SHROYER & ASSOCIATES LLC
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 1707 E MAIN ST STE 2
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City | OLNEY
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State | IL
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Zip | 62450-3156
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Country | US
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Telephone | 317-442-4437
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Fax |
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Provider Business Mailing Address
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Address Line | 1704 FRITSCHLE ST
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City | OLNEY
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State | IL
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Zip | 62450-2314
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Country | US
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Telephone | 618-839-3198
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YANCI SHROYER
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Credential |
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Telephone | 618-839-3198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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