Provider Demographics
NPI:1568581841
Name:YEARLING, DAVID ALLAN (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLAN
Last Name:YEARLING
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 1:16520 INGUADONA BEACH CIR SW
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-2368
Mailing Address - Country:US
Mailing Address - Phone:952-447-8572
Mailing Address - Fax:
Practice Address - Street 1:12940 HARRIET AVE S STE 240
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2680
Practice Address - Country:US
Practice Address - Phone:952-707-8588
Practice Address - Fax:952-707-8598
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNT78404Medicare UPIN