Provider Demographics
NPI:1356811392
Name:YOUNG, JEFFREY ALLEN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
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 1:4266 COTTAGE HILL RD
Mailing Address - Street 2:STE 4
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-4277
Mailing Address - Country:US
Mailing Address - Phone:251-666-1656
Mailing Address - Fax:
Practice Address - Street 1:4266 COTTAGE HILL RD
Practice Address - Street 2:STE 4
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4277
Practice Address - Country:US
Practice Address - Phone:251-666-1656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-03
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor