MEDICARE: YOUNG CHIROPRACTIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3256	MO

General Provider Information

NPI Number	:	1225221443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNG CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	6020 N ROBINSON AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7426
Country	:	US
Telephone Number	:	405-767-9750
Fax Number	:

Provider Business Practice Location Address
First Line	:	6020 N ROBINSON AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7426
Country	:	US
Telephone Number	:	405-767-9750
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY EARL YOUNG
Credential	:	D.C.
Telephone Number	:	405-767-9750

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	11/04/2015

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