Provider Demographics
NPI:1699812479
Name:YOUNG CHIROPRACTIC
Entity Type:Organization
Organization Name:YOUNG CHIROPRACTIC
Other - Org Name:GEORGE C.S. YOUNG, DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CONRAD SPENCER
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:906-932-6278
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-0297
Mailing Address - Country:US
Mailing Address - Phone:906-932-6278
Mailing Address - Fax:906-932-6279
Practice Address - Street 1:635 E CLOVERLAND DR
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-1403
Practice Address - Country:US
Practice Address - Phone:906-932-6278
Practice Address - Fax:906-932-6279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty