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General NPI Number Information
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NPI Number | 1205109972
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Entity Type | Individual
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Provider Name | JAMEKA RACINTA YOUNG PT, DPT, NREMT-P
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Gender | Female
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 1050 E MOUNTAIN VIEW AVE
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City | ELLENSBURG
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State | WA
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Zip | 98926-3930
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Country | US
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Telephone | 509-925-4171
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Fax |
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Provider Business Mailing Address
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Address Line | 10713 ALAMEDA DR
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City | KNOXVILLE
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State | TN
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Zip | 37932-2504
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Country | US
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Telephone | 865-300-5263
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Fax | 678-731-1659
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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 | 7080
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License Number State | TN
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