Provider Demographics
NPI:1740463991
Name:YEAROUT, KIM MICHELLE (LPT)
Entity type:Individual
Prefix:MS
First Name:KIM
Middle Name:MICHELLE
Last Name:YEAROUT
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
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Mailing Address - Street 1:9727 SHANNON WOODS
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-4102
Mailing Address - Country:US
Mailing Address - Phone:316-219-0253
Mailing Address - Fax:316-219-0254
Practice Address - Street 1:9727 SHANNON WOODS
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-4102
Practice Address - Country:US
Practice Address - Phone:316-219-0253
Practice Address - Fax:316-219-0254
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-010002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic