Provider Demographics
NPI:1770779159
Name:BRAD YOUNG D.C., P.C.
Entity type:Organization
Organization Name:BRAD YOUNG D.C., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-544-1401
Mailing Address - Street 1:1848 N HILL FIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2164
Mailing Address - Country:US
Mailing Address - Phone:801-544-1401
Mailing Address - Fax:801-544-1404
Practice Address - Street 1:1848 N HILL FIELD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2164
Practice Address - Country:US
Practice Address - Phone:801-544-1401
Practice Address - Fax:801-544-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4997956-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty