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General NPI Number Information
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NPI Number | 1831378835
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Entity Type | Individual
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Provider Name | JAMIE MICHELLE YOUNG D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 800 DUNLAWTON AVE STE 103
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City | PORT ORANGE
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State | FL
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Zip | 32127-4249
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Country | US
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Telephone | 386-677-6283
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Fax |
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Provider Business Mailing Address
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Address Line | 127 BRIARGATE LOOK
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City | ORMOND BEACH
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State | FL
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Zip | 32174-0728
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Country | US
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Telephone | 386-677-6283
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH9428
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License Number State | FL
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