MEDICARE: MRS. KRISTIN KELLY YACKEL-FRIEND PT

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	5501004788	MI

General Provider Information

NPI Number	:	1780186015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN KELLY YACKEL-FRIEND PT

Provider Business Mailing Address
First Line	:	9495 SCHOMAKER RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48609-9675
Country	:	US
Telephone Number	:	989-245-6446
Fax Number	:	989-791-1147

Provider Business Practice Location Address
First Line	:	5810 GRATIOT RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48638-6063
Country	:	US
Telephone Number	:	989-791-3771
Fax Number	:	989-791-1147

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

Provider Enumeration Date	:	03/02/2018
Last Update Date	:	03/02/2018

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Directions to “ MRS. KRISTIN KELLY YACKEL-FRIEND PT” Practice Location

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