Provider Demographics
NPI:1679840060
Name:YOUNG, KOREY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:KOREY
Middle Name:JAMES
Last Name:YOUNG
Suffix:
Gender:M
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:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:EMORY
Mailing Address - State:TX
Mailing Address - Zip Code:75440-0505
Mailing Address - Country:US
Mailing Address - Phone:903-473-0133
Mailing Address - Fax:
Practice Address - Street 1:410 E LENNON DR
Practice Address - Street 2:SUITE D
Practice Address - City:EMORY
Practice Address - State:TX
Practice Address - Zip Code:75440-3243
Practice Address - Country:US
Practice Address - Phone:903-473-0133
Practice Address - Fax:903-473-0136
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor