Individual
MCKENZIE R YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4 MEMORIAL DR STE 130, ALTON, IL 62002-6704
(618) 463-7600
Mailing address
4 MEMORIAL DR STE 130, ALTON, IL 62002-6704
(618) 463-7600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008385
IL
Other
Enumeration date
10/13/2020
Last updated
09/07/2022
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