Healthcare Provider Details

I. General information

NPI: 1457628729
Provider Name (Legal Business Name): TROY YOUNG PT, DPT, CERT ART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 GLEN ECHO RD STE 209
NASHVILLE TN
37215-2898
US

IV. Provider business mailing address

6983 LAGOON CT
JURUPA VALLEY CA
91752-2783
US

V. Phone/Fax

Practice location:
  • Phone: 615-840-3281
  • Fax:
Mailing address:
  • Phone: 714-767-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 35083
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number14325
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: