Provider Demographics
NPI:1710426101
Name:YETTON, STEVEN WILLIAM (ATC, LAT, PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:WILLIAM
Last Name:YETTON
Suffix:
Gender:M
Credentials:ATC, LAT, PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHINA GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28023-2304
Mailing Address - Country:US
Mailing Address - Phone:803-457-2471
Mailing Address - Fax:
Practice Address - Street 1:95 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-2304
Practice Address - Country:US
Practice Address - Phone:803-457-2471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
20000320432255A2300X
NCP116835146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer