Provider Demographics
NPI:1336569565
Name:PRICE, JAMIENNE YOUNG (DC)
Entity Type:Individual
Prefix:
First Name:JAMIENNE
Middle Name:YOUNG
Last Name:PRICE
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 1:580 DECKER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3961
Mailing Address - Country:US
Mailing Address - Phone:972-998-4100
Mailing Address - Fax:972-890-2385
Practice Address - Street 1:580 DECKER DR STE 201
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3961
Practice Address - Country:US
Practice Address - Phone:972-998-4100
Practice Address - Fax:972-890-2385
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor