Individual
DERICK YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6145 N 35TH AVE, PHOENIX, AZ 85017-1940
(602) 973-6561
Mailing address
18330 N 79TH AVE APT 2066, GLENDALE, AZ 85308-8351
(630) 205-4840
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S019606
AZ
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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