Doctor Name: | MR. RANDY YOUNG |
NPI Number: | 1346638665 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT,DPT |
License Number: | PT5620 |
Business Practice Address: | 40 Rosemont Dr Apt. F Grenada, MS - 389014065 |
Business Phone Number: | 6014152844 |
Business Fax Number: | |
Mailing Address: | 40 Rosemont Dr, Apt. F GRENADA |
State: | MS |
Postal Code: | 389014065 |
Phone Number: | 6014152844 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2015 |
NPI Last Update Date: | 01/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT5620 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |