Individual
MICHELLE DENISE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1228 GOLDEN LEAF RD, NATHALIE, VA 24577-3494
(336) 202-6838
Mailing address
1228 GOLDEN LEAF RD, NATHALIE, VA 24577-3494
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T60226887
VA
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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