Provider Demographics
NPI:1689837619
Name:YOST FAMILY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:YOST FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-728-3184
Mailing Address - Street 1:7144 NW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2773
Mailing Address - Country:US
Mailing Address - Phone:405-728-3184
Mailing Address - Fax:405-728-3186
Practice Address - Street 1:7144 NW 112TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-2773
Practice Address - Country:US
Practice Address - Phone:405-728-3184
Practice Address - Fax:405-728-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5454Medicare PIN