Provider Demographics
NPI:1689973547
Name:YOUNG CHIROPRACTIC
Entity Type:Organization
Organization Name:YOUNG CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-461-0038
Mailing Address - Street 1:11444 S APOPKA VINELAND RD # 106A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-7009
Mailing Address - Country:US
Mailing Address - Phone:407-238-2306
Mailing Address - Fax:407-238-2309
Practice Address - Street 1:11444 S APOPKA VINELAND RD # 106A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-7009
Practice Address - Country:US
Practice Address - Phone:407-238-2306
Practice Address - Fax:407-238-2309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty