Individual
MR. CHARLES-WARREN VICTOR YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MLA, ATC, LAT
Contact information
Practice address
ATHLETIC TRAINING ROOM, 5800 OWNBY DR., DALLAS, TX 75275-0001
(214) 768-1704
(214) 768-1225
Mailing address
ATHLETIC TRAINING ROOM, 5800 OWNBY DR., DALLAS, TX 75275-0001
(214) 768-1704
(214) 768-1225
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT2668
STATE ATHLETIC TRAINER LI
TX
Enumeration date
03/06/2007
Last updated
07/08/2007
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