Provider Demographics
NPI:1518602531
Name:YOUNG, ANJELICA
Entity Type:Individual
Prefix:
First Name:ANJELICA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 APPLEGATE CIR
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8856
Mailing Address - Country:US
Mailing Address - Phone:864-680-0359
Mailing Address - Fax:864-404-4824
Practice Address - Street 1:923 APPLEGATE CIR
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8856
Practice Address - Country:US
Practice Address - Phone:864-680-0359
Practice Address - Fax:864-404-4824
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management