Provider Demographics
NPI:1194943761
Name:YOUNG, ANN (LPTA)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 GARDEN PL
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5124
Mailing Address - Country:US
Mailing Address - Phone:330-414-1690
Mailing Address - Fax:
Practice Address - Street 1:1604 PATRIOTS PT SE
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-4828
Practice Address - Country:US
Practice Address - Phone:330-966-9165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1140225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant