Organization
KELLY YOUNG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY YOUNG (SOLE PROPRIETOR)
(256) 426-0020
Entity
Organization
Contact information
Practice address
1874 BELTLINE RD SW, DECATUR, AL 35601-5514
(256) 350-2211
Mailing address
222 BROCKTON DR, MADISON, AL 35756-4048
(256) 426-0020
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
1-117362
AL
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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