Yeske, Tara

Yeske, Tara is an sole proprietor health care provider with primary practice located at 4100 Lake Dr Se Suite 300, Grand Rapids MI 49546-8292. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, which is considered as her primary health care specialty. Yeske, Tara can be contacted via phone (616) 267-8860.

Contact Information

Primary practice address
4100 Lake Dr Se Suite 300 Grand Rapids MI 49546-8292
Phone: (616) 267-8860
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X 2601001079 Michigan

Profile Details

NPI number 1598195794
LBN Legal business name Yeske, Tara
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 25th, 2013
Last updated Nov 25th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598195794 NPPES
Michigan Other 2601001079 ATHLETIC TRAINING LICENSE

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