Provider Demographics
NPI:1104257179
Name:YURKO, CLAIRE MARIE (DPT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:YURKO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-954-7408
Practice Address - Street 1:2580 WINDY HILL RD
Practice Address - Street 2:STE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8642
Practice Address - Country:US
Practice Address - Phone:770-916-1567
Practice Address - Fax:770-916-1785
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011308225100000X
ALPTH7327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-56348OtherBCBS-ATHENS
511-56353OtherBCBS-CHELSEA
AL511-56356OtherBCBS-WEST MADISON
AL511-56354OtherBCBS-MOODY
AL102I652171OtherMEDICARE PTAN
AL511-56351OtherBCBS-HOOVER