Provider Demographics
NPI:1356854616
Name:YOUNG, JOSEPH MICHAEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:32 INDIAN ROCK RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1697
Mailing Address - Country:US
Mailing Address - Phone:603-505-0010
Mailing Address - Fax:603-890-8736
Practice Address - Street 1:32 INDIAN ROCK RD UNIT 5
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1697
Practice Address - Country:US
Practice Address - Phone:603-890-8541
Practice Address - Fax:603-890-8736
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist