Individual
PHILIP YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4841 LAKE PARK LANE, ACWORTH, GA 30101
(470) 578-4772
Mailing address
4841 LAKE PARK LANE, ACWORTH, GA 30101
(470) 578-4772
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001847
GA
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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