MEDICARE: DR. DEBRA YACKLEY D.C.

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	111N00000X	Chiropractor	1268	SD

General Provider Information

NPI Number	:	1285027987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA YACKLEY D.C.

Provider Business Mailing Address
First Line	:	5026 S MARION RD
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-6701
Country	:	US
Telephone Number	:	605-366-2178
Fax Number	:

Provider Business Practice Location Address
First Line	:	5026 S MARION RD
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-6701
Country	:	US
Telephone Number	:	605-366-2178
Fax Number	:

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

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	08/24/2017

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