Individual
CHAUTAUQUA N YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
5601 BRIDGE ST STE 490, FT WORTH, TX 76112-2306
(817) 446-5000
Mailing address
7103 MYNA DR, ARLINGTON, TX 76002-3385
(469) 223-9479
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2055893
TX
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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