Provider Demographics
NPI:1437481579
Name:YOUNG, WILLIAM ANDREW (LAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ANDREW
Last Name:YOUNG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 TENNYSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2104
Mailing Address - Country:US
Mailing Address - Phone:303-351-1228
Mailing Address - Fax:
Practice Address - Street 1:4022 TENNYSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2104
Practice Address - Country:US
Practice Address - Phone:303-351-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-30
Last Update Date:2010-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1435171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist