Doctor Name: | DR. BLAKE YOUNG |
NPI Number: | 1376901215 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C., R.N. |
License Number: | 13144 |
Business Practice Address: | 2412 College Hills Blvd Suite 206 San Angelo, TX - 769048474 |
Business Phone Number: | 3259491518 |
Business Fax Number: | 3252239290 |
Mailing Address: | 1314 S David St, SAN ANGELO |
State: | TX |
Postal Code: | 769037274 |
Phone Number: | 8175421017 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2016 |
NPI Last Update Date: | 02/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 13144 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |