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General NPI Number Information
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NPI Number | 1750654406
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Entity Type | Individual
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Provider Name | NICOLE S YOUNGS PT
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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 | 1419 BOARDMAN CANFIELD RD SUITE300
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City | BOARDMAN
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State | OH
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Zip | 44512-8062
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Country | US
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Telephone | 330-953-2383
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Fax | 330-953-2384
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Provider Business Mailing Address
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Address Line | 700 THORNBERRY TRL
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City | NORTH LIMA
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State | OH
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Zip | 44452-8508
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Country | US
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Telephone | 330-549-6029
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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 | 11276
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License Number State | OH
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