Provider Demographics
NPI:1497260632
Name:YACKLEY, CHRISTINA (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:YACKLEY
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 1:3405 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4417
Mailing Address - Country:US
Mailing Address - Phone:605-693-3405
Mailing Address - Fax:605-693-3404
Practice Address - Street 1:3405 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-4417
Practice Address - Country:US
Practice Address - Phone:605-693-7222
Practice Address - Fax:605-693-6614
Is Sole Proprietor?:No
Enumeration Date:2017-12-11
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1321OtherBCBS, DAKOTACARE, UHS, AVERA, SANFORD
SD1321Medicaid