MEDICARE: YOUNG CHIROPRACTIC INC

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	1716	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	282726456002	OTHER	MEDICAL MUTUAL OF OHIO
3	000000131591	OTHER	ANTHEM BC & BS

General Provider Information

NPI Number	:	1760518229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNG CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	PO BOX 325
Second Line	:
City	:	NEW WASHINGTON
State	:	OH
Zip	:	44854
Country	:	US
Telephone Number	:	419-492-2129
Fax Number	:	419-492-3344

Provider Business Practice Location Address
First Line	:	201S KIBLER ST
Second Line	:
City	:	NEW WASHINGTON
State	:	OH
Zip	:	44854
Country	:	US
Telephone Number	:	419-492-2129
Fax Number	:	419-492-3344

Authorized Official
Title or Position	:	CEO
Name	:	DR. THRESA MARIE YOUNG
Credential	:	DC
Telephone Number	:	419-492-2129

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/22/2020

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Directions to “YOUNG CHIROPRACTIC INC ” Practice Location

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