MEDICARE: MRS. ELIZABETH FREDERICK YOUNG P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305003507	VA
2	225100000X	Physical Therapist	PT870662	DC

General Provider Information

NPI Number	:	1366493843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH FREDERICK YOUNG P.T.

Provider Business Mailing Address
First Line	:	2501 N GLEBE RD STE 201
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-3558
Country	:	US
Telephone Number	:	703-469-3971
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 N GLEBE RD STE 201
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-3558
Country	:	US
Telephone Number	:	703-469-3971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	09/23/2010

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