MEDICARE: MS. CAROL ELIZABETH YOUORSKI CSA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZS0410X	Surgical Technologist

General Provider Information

NPI Number	:	1245381680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL ELIZABETH YOUORSKI CSA

Provider Business Mailing Address
First Line	:	3140 OLD ROCKBRIDGE RD
Second Line	:
City	:	AVONDALE ESTATES
State	:	GA
Zip	:	30002-1125
Country	:	US
Telephone Number	:	404-296-4101
Fax Number	:	404-501-0747

Provider Business Practice Location Address
First Line	:	3140 OLD ROCKBRIDGE RD
Second Line	:
City	:	AVONDALE ESTATES
State	:	GA
Zip	:	30002-1125
Country	:	US
Telephone Number	:	404-296-4101
Fax Number	:	404-501-0747

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2007
Last Update Date	:	07/08/2007

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