Provider Demographics
NPI:1699881375
Name:YEATTS, EMILY G (MSPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:G
Last Name:YEATTS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 E PITT ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-9723
Mailing Address - Country:US
Mailing Address - Phone:814-623-1436
Mailing Address - Fax:814-623-1921
Practice Address - Street 1:606 E PITT ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-9723
Practice Address - Country:US
Practice Address - Phone:814-623-1436
Practice Address - Fax:814-623-1921
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013916L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001859015Medicaid
PA1315086OtherHIGHMARK
PA001859015Medicaid
PA1315086OtherHIGHMARK