Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305204514 | VA |
NPI | 1043970619 |
---|---|
Provider Name | Michelle Anne Young |
First Address | Winchester, VA 22601-2800 |
Second Address | Winchester, VA 22601-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2021 |
Last Update Date | 23/12/2021 |