Provider Demographics
NPI:1851844484
Name:YOUNG, KELLY SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:SCOTT
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 14TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-3028
Mailing Address - Country:US
Mailing Address - Phone:814-643-0337
Mailing Address - Fax:814-643-3018
Practice Address - Street 1:929 14TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-3028
Practice Address - Country:US
Practice Address - Phone:814-643-0337
Practice Address - Fax:814-643-3018
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT025428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist