MEDICARE: MR. MICHAEL YOES JR. PT, MPT, CERT DN

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	07169	LA

General Provider Information

NPI Number	:	1710635099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL YOES JR. PT, MPT, CERT DN

Provider Business Mailing Address
First Line	:	4750 SHERWOOD COMMON BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4870
Country	:	US
Telephone Number	:	208-541-7849
Fax Number	:

Provider Business Practice Location Address
First Line	:	228 N LEWIS ST
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70563-2841
Country	:	US
Telephone Number	:	337-364-7496
Fax Number	:

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

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	03/15/2022

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