Provider Demographics
NPI:1407947831
Name:YARITZ, DEBRA ANNE I (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANNE
Last Name:YARITZ
Suffix:I
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 1:3589 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638-5405
Mailing Address - Country:US
Mailing Address - Phone:208-634-4878
Mailing Address - Fax:208-634-2317
Practice Address - Street 1:337 DEINHARD LN STE A
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638-4703
Practice Address - Country:US
Practice Address - Phone:208-634-4878
Practice Address - Fax:208-634-2317
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010146319OtherREGENCE BLUE SHIELD OF ID
IDC4264OtherBLUE CROSS OF IDAHO