Provider Demographics
NPI:1053057331
Name:YANOSCAK, TIANNA RACHEL
Entity Type:Individual
Prefix:
First Name:TIANNA
Middle Name:RACHEL
Last Name:YANOSCAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9890 STATE ROUTE 209
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17098-9468
Mailing Address - Country:US
Mailing Address - Phone:717-439-2804
Mailing Address - Fax:
Practice Address - Street 1:839 LINCOLN AVE STE 3
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4562
Practice Address - Country:US
Practice Address - Phone:484-887-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist