Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC005965L | PA |
NPI | 1003930306 |
---|---|
Provider Name | Dr. David R Yurescko |
First Address | Phila, PA 19114-2832 |
Second Address | Phila, PA 19114-2832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |