Individual
THEODORE YOUNG III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1099 W TOWN PKWY, ALTAMONTE SPRINGS, FL 32714-3845
(407) 865-8000
Mailing address
2272 HAWICK LN, WINTER PARK, FL 32792-4114
(407) 879-4379
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12693
FL
Other
Enumeration date
10/30/2015
Last updated
10/30/2015
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