Provider Demographics
NPI:1710635099
Name:YOES, MICHAEL JR (PT, MPT, CERT DN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:YOES
Suffix:JR
Gender:M
Credentials:PT, MPT, CERT DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 SHERWOOD COMMON BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4870
Mailing Address - Country:US
Mailing Address - Phone:208-541-7849
Mailing Address - Fax:
Practice Address - Street 1:228 N LEWIS ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2841
Practice Address - Country:US
Practice Address - Phone:337-364-7496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist