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Individual

DR. BLAKE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C., R.N.

Contact information

Practice address
1602 W AVENUE A, TEMPLE, TX 76504-4080
(254) 899-2225
Mailing address
1602 W AVENUE A, TEMPLE, TX 76504-4080
(254) 899-2225

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
13144
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
561631YXZK
MEDICARE
TX
Enumeration date
02/07/2016
Last updated
04/10/2018
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