=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427473685
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEVI YOUNKIN D.C
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2014
-----------------------------------------------------
Last Update Date | 02/25/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 216 CENTER AVE
-----------------------------------------------------
City | OAKLEY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67748-1714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-671-1270
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 216 CENTER AVE
-----------------------------------------------------
City | OAKLEY
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67748-1714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-671-1270
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 01-05603
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------