Individual
MRS. BERTIE SUE YERKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0872
OR
225100000X
Physical Therapist
PT002140L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210471
PERFORMING PROVIDER NUMBE
OR
Enumeration date
05/25/2007
Last updated
07/08/2007
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