Provider Demographics
NPI:1144309451
Name:YOUNG, LAURA PHILIPPS (MPT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:PHILIPPS
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102A SHARONDALE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-1200
Mailing Address - Country:US
Mailing Address - Phone:304-280-2286
Mailing Address - Fax:
Practice Address - Street 1:7105 S SPRINGS DR STE 200
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1787
Practice Address - Country:US
Practice Address - Phone:615-567-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204882225100000X
TN0000011609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist