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General NPI Number Information
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NPI Number | 1952494502
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Entity Type | Individual
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Provider Name | GLENDA J. YOUNG D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6 E 13TH ST
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City | FORT SCOTT
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State | KS
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Zip | 66701-2625
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Country | US
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Telephone | 620-223-6118
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Fax |
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Provider Business Mailing Address
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Address Line | 6 E. 13 ST.
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City | FT. SCOTT
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State | KS
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Zip | 66701
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Country | US
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Telephone | 620-223-6118
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P-237
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License Number State | KS
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