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Organization
JEFFREY DON LANGE
Active
Organization
JEFFREY DON LANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LANGE D.C. (OWNER)
(618) 524-7575
Entity
Organization
Contact information
Practice address
810 MARKET ST, METROPOLIS, IL 62960-1636
(618) 524-7575
(618) 524-7262
Mailing address
810 MARKET ST, METROPOLIS, IL 62960-1636
(618) 524-7575
(618) 524-7262
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007962
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038007962
—
IL
01
—
06422045
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
08/04/2006
Last updated
03/25/2011
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