Individual
MITCHEL YEAGY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 N EDGEWAY DR, ALEXANDRIA, IN 46001-1603
(765) 639-2192
Mailing address
305 N EDGEWAY DR, ALEXANDRIA, IN 46001-1603
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/16/2015
Last updated
10/16/2015
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