Provider Demographics
NPI:1083772180
Name:YAGER, THOMAS V
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:V
Last Name:YAGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 HIGHWAY 29 S STE 4055
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4525
Mailing Address - Country:US
Mailing Address - Phone:320-763-2889
Mailing Address - Fax:320-763-9540
Practice Address - Street 1:3015 HIGHWAY 29 S STE 4055
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4525
Practice Address - Country:US
Practice Address - Phone:320-763-2889
Practice Address - Fax:320-763-9540
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2302237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist