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General NPI Number Information
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NPI Number | 1265953707
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Entity Type | Individual
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Provider Name | ALEXIS VALE YELLAND
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Gender | Female
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 333 S CLARK ST
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City | HOPKINS
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State | MI
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Zip | 49328
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Country | US
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Telephone | 269-793-7616
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Fax |
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Provider Business Mailing Address
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Address Line | 278 JACKSON RD
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City | QUENEMO
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State | KS
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Zip | 66528-8251
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Country | US
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Telephone | 785-438-0642
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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