Provider Demographics
NPI:1497358428
Name:YOUNGEN, ABIGAIL L (DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:L
Last Name:YOUNGEN
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 1:1140 EDWARDS VILLAGE BLVD UNIT B208
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-5562
Mailing Address - Country:US
Mailing Address - Phone:970-569-3883
Mailing Address - Fax:
Practice Address - Street 1:1295 WESTHAVEN DR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657-4395
Practice Address - Country:US
Practice Address - Phone:970-476-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist