Individual
CHARLES DEYOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1015 WALNUT ST BLDG SUITE115, PHILADELPHIA, PA 19107-5005
(314) 566-1767
Mailing address
419 S CARLISLE ST, PHILADELPHIA, PA 19146-1615
(314) 566-1767
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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