Healthcare Provider Details

I. General information

NPI: 1326287533
Provider Name (Legal Business Name): YOUNG ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 02/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6137 EXECUTIVE BLVD
ROCKVILLE MD
20852
US

IV. Provider business mailing address

6137 EXECUTIVE BLVD
ROCKVILLE MD
20852
US

V. Phone/Fax

Practice location:
  • Phone: 301-770-6901
  • Fax: 301-770-9540
Mailing address:
  • Phone: 301-770-6901
  • Fax: 301-770-9540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104555714
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number01979
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number0104555714
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number01979
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number0104555714
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number01979
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0104555714
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number01979
License Number StateMD
# 9
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number0104555714
License Number StateVA
# 10
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number01979
License Number StateMD
# 11
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number0104555714
License Number StateVA
# 12
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01979
License Number StateMD

VIII. Authorized Official

Name: NATHALIE OKHOWAT
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-770-9601