Provider Demographics
NPI:1922606565
Name:YARUS, ABIGAIL
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:YARUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 BIG ROCK BLF
Mailing Address - Street 2:
Mailing Address - City:REXFORD
Mailing Address - State:MT
Mailing Address - Zip Code:59930-9502
Mailing Address - Country:US
Mailing Address - Phone:406-471-8503
Mailing Address - Fax:
Practice Address - Street 1:204 DEWEY AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9046
Practice Address - Country:US
Practice Address - Phone:406-471-8503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17975225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist