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General NPI Number Information
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NPI Number | 1134397045
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Entity Type | Individual
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Provider Name | BRADLEY B YOTTY DPT
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Gender | Male
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 10118 MAPLE ST
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City | OMAHA
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State | NE
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Zip | 68134-5555
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Country | US
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Telephone | 402-939-7939
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Fax | 402-939-7940
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Provider Business Mailing Address
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Address Line | 2008 CEDAR PLAZA DR
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City | MUSCATINE
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State | IA
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Zip | 52761-2285
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Country | US
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Telephone | 563-264-8638
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Fax | 563-264-8639
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004155
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License Number State | IA
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