Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08005215A | IN |
NPI | 1003129966 |
---|---|
Provider Name | Dr. Stacey Haas Young |
First Address | Westfield, IN 46074-6015 |
Second Address | Westfield, IN 46074-9440 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2010 |
Last Update Date | 21/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201152900A | (05) | IN |