Individual
CASEY LEE YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3801 UNIVERSITY DR, FAIRFAX, VA 22030-2503
(703) 383-8130
Mailing address
8910 JACKSON AVE, MANASSAS, VA 20110-4958
(703) 853-5416
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
0110009393
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2021
Last updated
08/30/2024
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