Provider Demographics
NPI:1801481023
Name:YODER, VICTORIA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:YODER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7562 TANGLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9037
Mailing Address - Country:US
Mailing Address - Phone:336-408-4362
Mailing Address - Fax:
Practice Address - Street 1:320 JAKE ALEXANDER BLVD W STE 106
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-1442
Practice Address - Country:US
Practice Address - Phone:704-636-0052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist