MEDICARE: CHENELE YOUNG

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	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1538979208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHENELE YOUNG

Provider Business Mailing Address
First Line	:	1733 MIDWAY MALL # 1064
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-2478
Country	:	US
Telephone Number	:	440-283-9109
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 LOWELL ST
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-4849
Country	:	US
Telephone Number	:	440-283-9109
Fax Number	:

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

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	01/13/2025

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Directions to “ CHENELE YOUNG ” Practice Location

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