Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA001975L | PA |
N | 2251E1200X | Ergonomics | OTA001975L | PA |
N | 225XE1200X | Ergonomics | OTA001975L | PA |
NPI | 1467930636 |
---|---|
Provider Name | Darryl Lynn Yusko |
First Address | Dillsburg, PA 17019-9742 |
Second Address | Dillsburg, PA 17019-9742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2018 |
Last Update Date | 31/07/2018 |