Individual
MISS TAMMY LOU YAZEVAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1370 JOHNSON AVE, BRIDGEPORT, WV 26330-1492
(304) 842-7186
(304) 842-2533
Mailing address
900 FAIRMONT RD, MORGANTOWN, WV 26501-3847
(304) 598-2233
(304) 296-1792
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
273
WV
Other
Enumeration date
05/18/2011
Last updated
07/10/2015
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