Individual
DAKOTA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
361 W MAIN ST, ALBION, IL 62806-1071
(618) 599-1339
Mailing address
1527 COLLEGE DRIVE, MT. CARMEL, IL 62863
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004937
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096004937
STATE
IL
Enumeration date
07/01/2022
Last updated
07/12/2022
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