Provider Demographics
NPI:1891063327
Name:YOUNG CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:YOUNG CHIROPRACTIC, PLLC
Other - Org Name:NEW LIFE CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:830-620-0010
Mailing Address - Street 1:457 LANDA ST STE J
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5414
Mailing Address - Country:US
Mailing Address - Phone:830-620-0010
Mailing Address - Fax:
Practice Address - Street 1:457 LANDA ST STE J
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5414
Practice Address - Country:US
Practice Address - Phone:830-620-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11848111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty