MEDICARE: YOUNG CHIROPRACTIC, PLLC

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	11848	TX

General Provider Information

NPI Number	:	1891063327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNG CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	457 LANDA ST STE J
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5414
Country	:	US
Telephone Number	:	830-620-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	457 LANDA ST STE J
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5414
Country	:	US
Telephone Number	:	830-620-0010
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DEVIN YOUNG
Credential	:	D.C.
Telephone Number	:	830-620-0010

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	12/12/2011

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