Provider Demographics
NPI:1407901242
Name:YALE, DAVID T (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:YALE
Suffix:
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 1:2955 1/2 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5321
Mailing Address - Country:US
Mailing Address - Phone:970-523-1244
Mailing Address - Fax:970-644-5233
Practice Address - Street 1:2955 1/2 NORTH AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5321
Practice Address - Country:US
Practice Address - Phone:970-523-1244
Practice Address - Fax:970-644-5233
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU18793Medicare UPIN
COC14703Medicare PIN