Provider Demographics
NPI:1689329211
Name:YORK, VICTORIA LYNN
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:LYNN
Last Name:YORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:RAMER
Mailing Address - State:TN
Mailing Address - Zip Code:38367-6260
Mailing Address - Country:US
Mailing Address - Phone:731-439-1430
Mailing Address - Fax:
Practice Address - Street 1:1050 UNION UNIVERSITY DR # UU2246
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3656
Practice Address - Country:US
Practice Address - Phone:731-439-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer