Individual
KYLE YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1416 FAIRGROUNDS RD, JEFFERSON CTY, MO 65109-0474
(573) 280-6494
Mailing address
1416 FAIRGROUNDS RD, JEFFERSON CTY, MO 65109-0474
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103196
MN
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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