Provider Demographics
NPI:1285975714
Name:YANKE, JOSEPH M (CO, LO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:YANKE
Suffix:
Gender:M
Credentials:CO, LO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4626
Mailing Address - Country:US
Mailing Address - Phone:330-821-4918
Mailing Address - Fax:330-821-3923
Practice Address - Street 1:1220 W STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4626
Practice Address - Country:US
Practice Address - Phone:330-821-4918
Practice Address - Fax:330-821-3923
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLO-0223222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2046851Medicaid