Provider Demographics
NPI:1639734205
Name:YOUNG, MICHAEL C (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:C
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S KENTON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3147
Mailing Address - Country:US
Mailing Address - Phone:608-334-4578
Mailing Address - Fax:
Practice Address - Street 1:8 W DRY CREEK CIR STE 130
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4477
Practice Address - Country:US
Practice Address - Phone:303-955-8163
Practice Address - Fax:720-387-7244
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0015544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist