Provider Demographics
NPI:1366976904
Name:HEDRICK, MONICA YOUNG (LPT)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:YOUNG
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 J A YOUNT FARM RD
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8945
Mailing Address - Country:US
Mailing Address - Phone:828-464-1845
Mailing Address - Fax:
Practice Address - Street 1:3031 TATE BLVD SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1455
Practice Address - Country:US
Practice Address - Phone:828-322-3343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP7687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist