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General NPI Number Information
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NPI Number | 1891232153
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Entity Type | Organization
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Legal Business Name | YOUNG CHIROPRACTIC & ACUPUNCTURE, LTD.
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 2911 CROSSING COURT SUITE 101
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City | CHAMPAIGN
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State | IL
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Zip | 61822-6108
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Country | US
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Telephone | 217-359-0550
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Fax | 217-359-0808
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Provider Business Mailing Address
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Address Line | 2911 CROSSING COURT SUITE 101
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City | CHAMPAIGN
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State | IL
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Zip | 61822-6108
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Country | US
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Telephone | 217-359-0550
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Fax | 217-359-0808
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. KASSIE JEAN YOUNG
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Credential | D.C.
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Telephone | 217-359-0550
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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 | 038.012380
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.012380
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License Number State |
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