Provider Demographics
NPI:1528758752
Name:YURICH, ZACHARY
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:YURICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7862 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44215-9766
Mailing Address - Country:US
Mailing Address - Phone:330-410-9089
Mailing Address - Fax:
Practice Address - Street 1:7862 LAKE RD
Practice Address - Street 2:
Practice Address - City:CHIPPEWA LAKE
Practice Address - State:OH
Practice Address - Zip Code:44215-9766
Practice Address - Country:US
Practice Address - Phone:330-410-9089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program