Provider Demographics
NPI:1811186166
Name:YARBORO, DOUGLAS DEVENNY (DPT)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:DEVENNY
Last Name:YARBORO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 S SOUTH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-4491
Mailing Address - Country:US
Mailing Address - Phone:336-786-2033
Mailing Address - Fax:
Practice Address - Street 1:314 S SOUTH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-4491
Practice Address - Country:US
Practice Address - Phone:336-786-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist