Provider Demographics
NPI:1700287075
Name:YORK, DUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:
Last Name:YORK
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 1:516 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-8013
Mailing Address - Country:US
Mailing Address - Phone:405-659-3752
Mailing Address - Fax:
Practice Address - Street 1:516 2ND ST NW
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078-8013
Practice Address - Country:US
Practice Address - Phone:405-659-3752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor