Provider Demographics
NPI:1417927567
Name:YOUNG, ALIANN M (DC)
Entity Type:Individual
Prefix:DR
First Name:ALIANN
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 STONEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4714
Mailing Address - Country:US
Mailing Address - Phone:440-522-8673
Mailing Address - Fax:440-934-0881
Practice Address - Street 1:2342 STONEWOOD ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4714
Practice Address - Country:US
Practice Address - Phone:440-522-8673
Practice Address - Fax:440-934-0881
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3667111N00000X
NJ38MC05645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU79863Medicare UPIN
OHY04200121Medicare PIN