Provider Demographics
NPI:1851079727
Name:YOUNG, JOHN WESLEY JR (DOCTOR OF SCIENCE)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:DOCTOR OF SCIENCE
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Other - Credentials:
Mailing Address - Street 1:5510 CHEROKEE AVE
Mailing Address - Street 2:STE 300 #1233
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312
Mailing Address - Country:US
Mailing Address - Phone:703-822-5669
Mailing Address - Fax:
Practice Address - Street 1:134 COCHISE TRL
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-1511
Practice Address - Country:US
Practice Address - Phone:202-276-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach