MEDICARE: YODER CHIROPRACTIC INC

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	CH 6408	FL

General Provider Information

NPI Number	:	1326224759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YODER CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	845 TEAGUE TRL
Second Line	:	SUITE 3
City	:	LADY LAKE
State	:	FL
Zip	:	32159-3104
Country	:	US
Telephone Number	:	352-751-5083
Fax Number	:	352-751-5376

Provider Business Practice Location Address
First Line	:	845 TEAGUE TRL
Second Line	:	SUITE 3
City	:	LADY LAKE
State	:	FL
Zip	:	32159-3104
Country	:	US
Telephone Number	:	352-751-5083
Fax Number	:	352-751-5376

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PATRICIA YODER
Credential	:	DC
Telephone Number	:	352-751-5083

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	12/20/2011

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