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General NPI Number Information
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NPI Number | 1134784556
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Entity Type | Individual
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Provider Name | MICHELLE YOUNG
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Gender | Female
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 835 CENTRAL AVE STE 301
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City | HOT SPRINGS
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State | AR
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Zip | 71901-5310
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Country | US
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Telephone | 310-227-5761
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Fax |
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Provider Business Mailing Address
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Address Line | 109 SHAMROCK LN
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City | HOT SPRINGS
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State | AR
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Zip | 71913-9284
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Country | US
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Telephone | 310-227-5761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT4583
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License Number State | AR
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