Provider Demographics
NPI:1821304981
Name:YODER, PATRICK (ATC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:YODER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INDIANA STATE UNIVERSITY
Mailing Address - Street 2:STUDENT SERVICES BUILDING, ROOM 201
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47809-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:INDIANA STATE UNIVERSITY
Practice Address - Street 2:STUDENT SERVICES BUILDING, ROOM 201
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47809-0001
Practice Address - Country:US
Practice Address - Phone:812-237-8232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer