Individual
JESSE T YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-4783
(608) 785-0940
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
(715) 838-5895
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
105562
MN
2085R0202X
Diagnostic Radiology Physician
54646
MN
2085R0202X
Diagnostic Radiology Physician
Primary
65759
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2010
Last updated
10/27/2020
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