Individual
JONATHAN YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15368 BROWNELL RD, BEULAH, MI 49617-9754
(231) 325-2123
Mailing address
PO BOX 284, INTERLOCHEN, MI 49643-0284
(231) 325-2123
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704215631
MI
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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