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General NPI Number Information
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NPI Number | 1851732630
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Entity Type | Individual
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Provider Name | JUBIL YOUNG D.P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 1000 GRANBY PARK DRIVE SOUTH
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City | GRANBY
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State | CO
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Zip | 80446
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Country | US
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Telephone | 970-887-5851
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | KREMMLING
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State | CO
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Zip | 80459-0399
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Country | US
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Telephone |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PTL.0012249
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-3218
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License Number State | ID
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