Organization
DR.CHARLES YEAGER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES SCOTT YEAGER IV DPM (PODIATRIST)
(717) 475-1455
Entity
Organization
Contact information
Practice address
1 MASONIC DR, ELIZABETHTOWN, PA 17022-2199
(717) 367-1121
(717) 361-4525
Mailing address
29 CLOISTER AVE, EPHRATA, PA 17522-1701
(717) 733-5556
(717) 721-8139
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SC002211L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000587897
—
PA
Enumeration date
03/25/2017
Last updated
04/25/2017
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