Provider Demographics
NPI:1164485207
Name:SINCLAIR, DEBORAH YEAKLE (DC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:YEAKLE
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8080 RITZ PINE DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8745
Mailing Address - Country:US
Mailing Address - Phone:616-874-1120
Mailing Address - Fax:
Practice Address - Street 1:710 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-2054
Practice Address - Country:US
Practice Address - Phone:616-754-9172
Practice Address - Fax:616-754-1067
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007345111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4802750Medicaid
MI4802750Medicaid