Individual
MS. TERRY E YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
5949 HAWTHORNE RD, MOUND, MN 55364-8527
(952) 472-3631
Mailing address
5949 HAWTHORNE RD, MOUND, MN 55364-8527
(952) 472-3631
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A353
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A353
PTA LICENSURE
MN
Enumeration date
03/04/2016
Last updated
03/04/2016
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