Provider Demographics
NPI:1831697127
Name:YOUNKINS, DAVID (LMT, CNS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:YOUNKINS
Suffix:
Gender:M
Credentials:LMT, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4037 TRISHA TRL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3460
Mailing Address - Country:US
Mailing Address - Phone:804-709-6269
Mailing Address - Fax:
Practice Address - Street 1:4037 TRISHA TRL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3460
Practice Address - Country:US
Practice Address - Phone:804-709-6269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACNS18875133N00000X
VA0019016105225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist