MEDICARE: JACOB YOST IV

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	225100000X	Physical Therapist	2305211380	VA

General Provider Information

NPI Number	:	1659916781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB YOST IV

Provider Business Mailing Address
First Line	:	136 LINDEN DR STE 104
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7793 MAIN ST
Second Line	:
City	:	MIDDLETOWN
State	:	VA
Zip	:	22645-9502
Country	:	US
Telephone Number	:	540-667-9252
Fax Number	:

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

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	06/17/2024

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Directions to “ JACOB YOST IV ” Practice Location

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