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General NPI Number Information
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NPI Number | 1710426101
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Entity Type | Individual
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Provider Name | STEVEN WILLIAM YETTON ATC, LAT, PARAMEDIC
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Gender | Male
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 95 CENTRAL AVE
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City | CHINA GROVE
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State | NC
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Zip | 28023-2304
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Country | US
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Telephone | 803-457-2471
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Fax |
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Provider Business Mailing Address
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Address Line | 95 CENTRAL AVE
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City | CHINA GROVE
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State | NC
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Zip | 28023-2304
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Country | US
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Telephone | 803-457-2471
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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 | 2000032043
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License Number State |
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Taxonomy #2
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Taxonomy Code | 146L00000X
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Taxonomy Name | Paramedic
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License Number | P116835
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License Number State | NC
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