Organization
YOUNG PERFORMANCE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE YOUNG D.C., R.N. (OWNER/ CHIROPRACTOR)
(817) 542-1017
Entity
Organization
Contact information
Practice address
4568 S HIGHLAND DR, SUITE 150, SALT LAKE CITY, UT 84117-4263
(817) 542-1017
Mailing address
1044 E QUAIL PARK DR, APT H, SALT LAKE CITY, UT 84117-7903
(817) 542-1017
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
87912941202
UT
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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