# DEYARD WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306246319
- **Authorized official:** LAURA YARD MD (VP)
- **Authorized official phone:** (386) 322-3505

## Contact information

- **Practice address:** 1728 DUNLAWTON AVE, STE 2, PORT ORANGE, FL 32127-2922
- **Practice address phone:** (386) 322-3505
- **Practice address fax:** (386) 322-3509
- **Mailing address:** 1728 DUNLAWTON AVE, STE 2, PORT ORANGE, FL 32127-2922
- **Mailing address phone:** (386) 322-3505
- **Mailing address fax:** (386) 322-3509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | ME68224 | FL | Yes |

## Other

- **Enumeration date:** 08/27/2014
- **Last updated:** 08/27/2014