Provider Demographics
NPI:1902953326
Name:YOUNG, GEORGE C S (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C S
Last Name:YOUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 MILL ST
Mailing Address - Street 2:
Mailing Address - City:MUNISING
Mailing Address - State:MI
Mailing Address - Zip Code:49862-1431
Mailing Address - Country:US
Mailing Address - Phone:906-387-4955
Mailing Address - Fax:906-387-1565
Practice Address - Street 1:423 MILL ST
Practice Address - Street 2:
Practice Address - City:MUNISING
Practice Address - State:MI
Practice Address - Zip Code:49862-1431
Practice Address - Country:US
Practice Address - Phone:906-387-4955
Practice Address - Fax:906-387-1565
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU98478Medicare UPIN