Provider Demographics
NPI:1861431678
Name:YOUNG, BURTON T (DC)
Entity type:Individual
Prefix:DR
First Name:BURTON
Middle Name:T
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 1:7665 MONARCH CT. SUITE 110
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069
Mailing Address - Country:US
Mailing Address - Phone:513-777-9428
Mailing Address - Fax:513-777-3628
Practice Address - Street 1:7665 MONARCH CT. SUITE 110
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069
Practice Address - Country:US
Practice Address - Phone:513-777-9428
Practice Address - Fax:513-777-3628
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00069171100000X
OH1657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0892431Medicaid
OHYO0684252Medicare ID - Type Unspecified
OH0892431Medicaid