Healthcare Provider Details

I. General information

NPI: 1033293014
Provider Name (Legal Business Name): MICHAEL WILLIAM YOUNGQUIST DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 45TH AVE SE
WILLMAR MN
56201
US

IV. Provider business mailing address

PO BOX 1536
WILLMAR MN
56201
US

V. Phone/Fax

Practice location:
  • Phone: 320-235-5444
  • Fax: 320-231-0937
Mailing address:
  • Phone: 320-235-5444
  • Fax: 320-231-0937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2415
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2415
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: