Healthcare Provider Details

I. General information

NPI: 1396705281
Provider Name (Legal Business Name): SHARON B YOUNG PT, DSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON B RHODES

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 AIRPORT BLVD STE A-1
MOBILE AL
36608
US

IV. Provider business mailing address

901 LOCKENBIE PL
DAUPHIN ISLAND AL
36528-4438
US

V. Phone/Fax

Practice location:
  • Phone: 251-460-0201
  • Fax: 251-460-2848
Mailing address:
  • Phone: 251-404-9502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH1107
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: