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General NPI Number Information
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NPI Number | 1871987248
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Entity Type | Organization
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Legal Business Name | A. YOUNG INCORPORATED
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 2404 S ORCHARD ST STE 800
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City | BOISE
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State | ID
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Zip | 83705-6725
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Country | US
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Telephone | 208-345-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 3256 W AGATE CT
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City | BOISE
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State | ID
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Zip | 83705-1770
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Country | US
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Telephone | 208-724-0990
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JENNIFER CLOVER
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Credential |
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Telephone | 208-345-2222
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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 |
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License Number State |
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