Provider Demographics
NPI:1265953707
Name:YELLAND, ALEXIS VALE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:VALE
Last Name:YELLAND
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 1:278 JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:QUENEMO
Mailing Address - State:KS
Mailing Address - Zip Code:66528-8251
Mailing Address - Country:US
Mailing Address - Phone:785-438-0642
Mailing Address - Fax:
Practice Address - Street 1:333 S CLARK ST
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MI
Practice Address - Zip Code:49328
Practice Address - Country:US
Practice Address - Phone:269-793-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer