Provider Demographics
NPI:1528219847
Name:YEAGER, RAYMOND CHAD (DC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:CHAD
Last Name:YEAGER
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 1:1991 TOWER DR STE G
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2388
Mailing Address - Country:US
Mailing Address - Phone:405-735-8282
Mailing Address - Fax:
Practice Address - Street 1:1991 TOWER DR STE G
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2388
Practice Address - Country:US
Practice Address - Phone:405-735-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor