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Individual

JACKY RAY LANGSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
115 E 5TH ST, TUSCUMBIA, AL 35674-2409
(256) 383-6238
(256) 383-6234
Mailing address
PO BOX 256, TUSCUMBIA, AL 35674-0256
(256) 383-6238
(256) 383-6234

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
744
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51002591
BC/BS
AL
01
51073375
AETNA
AL
Enumeration date
10/10/2005
Last updated
07/08/2007
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