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NPI 1811604911

NPI 1811604911 : BRIANNE YOUNG DPT : ROCHESTER, NY

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General NPI Number Information
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    NPI Number           |    1811604911
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    Entity Type          |    Individual 
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    Provider Name        |    BRIANNE YOUNG DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/31/2022
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    Last Update Date     |    10/31/2022
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Provider Practice Location Address
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    Address Line         |    1425 PORTLAND AVE 
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    City                 |    ROCHESTER
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    State                |    NY
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    Zip                  |    14621-3011
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    Country              |    US
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    Telephone            |    585-313-5993
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4 HARA CRES 
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    City                 |    FAIRPORT
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    State                |    NY
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    Zip                  |    14450-1115
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    Country              |    US
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    Telephone            |    585-313-5993
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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       |    025304
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    License Number State |    NY
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