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General NPI Number Information
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NPI Number | 1134459704
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Entity Type | Organization
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Legal Business Name | YEAGER PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 01/05/2010
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 930 DOWDELL LN
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City | SAINT HELENA
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State | CA
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Zip | 94574-1452
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Country | US
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Telephone | 707-967-0510
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Fax | 707-967-0515
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Provider Business Mailing Address
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Address Line | PO BOX 74
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City | ANGWIN
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State | CA
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Zip | 94508-0074
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Country | US
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Telephone | 707-965-9828
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Fax | 707-967-0515
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL YEAGER
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Credential | PT
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Telephone | 707-260-5164
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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 | PT14117
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License Number State | CA
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