Provider Demographics
NPI:1073998241
Name:YAKIMEC, GREGORY MICHAEL (DPT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:MICHAEL
Last Name:YAKIMEC
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1585 MID VALLEY DR
Mailing Address - Street 2:STE 3
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-9099
Mailing Address - Country:US
Mailing Address - Phone:970-879-8026
Mailing Address - Fax:970-879-8046
Practice Address - Street 1:21 DIVISION ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5301
Practice Address - Country:US
Practice Address - Phone:401-433-4172
Practice Address - Fax:401-433-0612
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02773225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist