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Individual

DR. KEVIN L. LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, DACRB, FMS, CSCS

Contact information

Practice address
3141 COLUMBIA AVE, LANCASTER, PA 17603-4012
(717) 394-6558
(717) 394-6813
Mailing address
3141 COLUMBIA AVE, LANCASTER, PA 17603-4012
(717) 394-6558
(717) 394-6813

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC006842-L
PA
111NX0100X
Occupational Health Chiropractor
DC006842-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LO445351
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
09/14/2006
Last updated
05/26/2015
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