Provider Demographics
NPI:1255476024
Name:YENZER, JAMES W JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:YENZER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N NAVY BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-1208
Mailing Address - Country:US
Mailing Address - Phone:850-457-7999
Mailing Address - Fax:850-457-7917
Practice Address - Street 1:610 N NAVY BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-1242
Practice Address - Country:US
Practice Address - Phone:850-457-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL608821200OtherDEPARTMENT OF LABOR
FL050670200Medicaid
FL22397ZMedicare PIN
FL608821200OtherDEPARTMENT OF LABOR