Provider Demographics
NPI:1750714416
Name:MCCREADY, JOHN YOUNG (DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:YOUNG
Last Name:MCCREADY
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 1:102 THOMAS RD STE 501
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5549
Mailing Address - Country:US
Mailing Address - Phone:318-614-8455
Mailing Address - Fax:
Practice Address - Street 1:102 THOMAS RD STE 501
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5549
Practice Address - Country:US
Practice Address - Phone:318-614-8455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-17
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
686675OtherMEDICARE #