Provider Demographics
NPI:1740775410
Name:YOVINO, PHILLIP LEE
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:LEE
Last Name:YOVINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 N POINT PKWY STE D100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5700
Mailing Address - Country:US
Mailing Address - Phone:770-475-7272
Mailing Address - Fax:770-475-7270
Practice Address - Street 1:3155 N POINT PKWY STE D100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5700
Practice Address - Country:US
Practice Address - Phone:770-475-7272
Practice Address - Fax:770-475-7270
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant