Provider Demographics
NPI:1962717439
Name:YODER, SAMUEL FRANK JR (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:FRANK
Last Name:YODER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1126
Mailing Address - Country:US
Mailing Address - Phone:717-248-8484
Mailing Address - Fax:717-242-8558
Practice Address - Street 1:505 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1126
Practice Address - Country:US
Practice Address - Phone:717-248-8484
Practice Address - Fax:717-242-8558
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor