Individual
CHARLEY YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC
Contact information
Practice address
1118 STATE ST APT H, QUINCY, IL 62301-4900
(701) 261-0822
Mailing address
1118 STATE ST APT H, QUINCY, IL 62301-4900
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003691
IL
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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