Provider Demographics
NPI:1568974376
Name:NEWTON G YCO PC
Entity Type:Organization
Organization Name:NEWTON G YCO PC
Other - Org Name:YCO FRIENDLY WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-737-3720
Mailing Address - Street 1:255 W PECKHAM LN STE 2
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5460
Mailing Address - Country:US
Mailing Address - Phone:775-853-8888
Mailing Address - Fax:775-853-8288
Practice Address - Street 1:255 W PECKHAM LN STE 2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5460
Practice Address - Country:US
Practice Address - Phone:775-853-8888
Practice Address - Fax:775-853-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty