Individual
MR. JOHN OWEN YOUNGBLOOD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
1501 MERCER UNIVERSITY DR, MACON, GA 31207-1515
(478) 955-1587
Mailing address
1501 MERCER UNIVERSITY DR, MACON, GA 31207-1515
(478) 955-1587
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002123
GA
Other
Enumeration date
08/08/2016
Last updated
08/08/2016
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