MEDICARE: MS. MARCY KATHERINE YAUCHLER MTA

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	246ZA2600X	Medical Art Specialist/Technologist	52441455941	FL

General Provider Information

NPI Number	:	1376068072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARCY KATHERINE YAUCHLER MTA

Provider Business Mailing Address
First Line	:	1740 ROSERY RD NE
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33771-1682
Country	:	US
Telephone Number	:	727-638-0994
Fax Number	:

Provider Business Practice Location Address
First Line	:	35080 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1925
Country	:	US
Telephone Number	:	727-789-5711
Fax Number	:

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

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	08/03/2017

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