Provider Demographics
NPI:1962462333
Name:YALE, KAREN ANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANNE
Last Name:YALE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28315 S TAMIAMI TR
Mailing Address - Street 2:#101
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134
Mailing Address - Country:US
Mailing Address - Phone:239-947-1177
Mailing Address - Fax:239-947-6399
Practice Address - Street 1:28315 S TAMIAMI TR
Practice Address - Street 2:#101
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134
Practice Address - Country:US
Practice Address - Phone:239-947-1177
Practice Address - Fax:239-947-6399
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5870111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T87704Medicare UPIN
FL22302YMedicare ID - Type Unspecified