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General NPI Number Information
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NPI Number | 1407160294
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Entity Type | Organization
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Legal Business Name | CHAD R. YOUNG, DC. PLLC
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 2321 7TH AVE N
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City | ANOKA
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State | MN
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Zip | 55303
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Country | US
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Telephone | 763-439-4634
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Fax | 763-445-2121
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Provider Business Mailing Address
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Address Line | 964 121ST LN NW
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City | COON RAPIDS
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State | MN
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Zip | 55448-2139
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Country | US
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Telephone | 763-439-4634
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Fax | 763-445-2121
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAD RICHARD YOUNG
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Credential | D.C.
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Telephone | 763-439-4634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5013
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License Number State | MN
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