Individual
ERIC DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
13100 EASTPOINT PARK BLVD, SUITE 200, LOUISVILLE, KY 40223-3157
(502) 245-0767
(502) 245-1380
Mailing address
13100 EASTPOINT PARK BLVD, SUITE 200, LOUISVILLE, KY 40223-3157
(502) 245-0767
(502) 245-1380
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R1714
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343513
ANTHEM
KY
Enumeration date
03/08/2007
Last updated
07/08/2007
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