Provider Demographics
NPI:1225622848
Name:YERVASI, AIMEE O (DC, ATC)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:O
Last Name:YERVASI
Suffix:
Gender:F
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 575
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-0575
Mailing Address - Country:US
Mailing Address - Phone:770-658-6311
Mailing Address - Fax:
Practice Address - Street 1:305 NOAH DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-8723
Practice Address - Country:US
Practice Address - Phone:706-253-9355
Practice Address - Fax:706-253-9352
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0027602255A2300X
GACHIR010481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer