Individual
DR. GLORIA JEAN YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4501 CAPPER RD. #A212, JACKSONVILLE, FL 32218-7148
(205) 567-4196
(904) 619-5622
Mailing address
PO BOX 77148, JACKSONVILLE, FL 32226-7148
(205) 567-4196
(904) 619-5622
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PT10019
FL
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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