Provider Demographics
NPI:1861580888
Name:YOUNG, JAMES BRADLEY (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRADLEY
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 1:1848 N HILL FIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2218
Mailing Address - Country:US
Mailing Address - Phone:801-544-1401
Mailing Address - Fax:
Practice Address - Street 1:1848 N HILL FIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2218
Practice Address - Country:US
Practice Address - Phone:801-544-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49979561202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
49979561277001OtherBLUE CROSS BLUE SHIELD
9341754OtherPRIVATE HEALTHCARE SYSTEM
66300OtherPEHP
54873OtherALTIUS
1038730OtherAMERICAN SPECIALTY HEALTH
UT1770779159Medicaid
870395551YNGOtherEDUCATORS MUTUAL
9341754OtherPRIVATE HEALTHCARE SYSTEM
000056356Medicare ID - Type Unspecified