Provider Demographics
NPI:1326232836
Name:BAUTISTA- YEAGER, ELENITA FIDELINO (PHYSICAL THERAPY)
Entity type:Individual
Prefix:MRS
First Name:ELENITA
Middle Name:FIDELINO
Last Name:BAUTISTA- YEAGER
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
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Mailing Address - Street 1:103 W KELLER ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6336
Mailing Address - Country:US
Mailing Address - Phone:717-766-7491
Mailing Address - Fax:717-766-7457
Practice Address - Street 1:1700 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4817
Practice Address - Country:US
Practice Address - Phone:717-737-8551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2023-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAPT-010965L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist