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Individual
DUANE YOUNG
Active
Individual
DUANE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
1053106
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266512
BLUE CROSS
MO
Enumeration date
07/16/2014
Last updated
07/16/2014
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