Provider Demographics
NPI:1952598096
Name:YOUNG CHIROPRACTIC & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:YOUNG CHIROPRACTIC & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:K
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:402-339-2283
Mailing Address - Street 1:10351 PORTAL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-5543
Mailing Address - Country:US
Mailing Address - Phone:402-339-2283
Mailing Address - Fax:402-339-2289
Practice Address - Street 1:10351 PORTAL RD STE 103
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-5543
Practice Address - Country:US
Practice Address - Phone:402-339-2283
Practice Address - Fax:402-339-2289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty