Individual
DR. MONTY CORNELL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
86 FRONTAGE RD., DUNLAP, TN 37327
(423) 949-5599
(423) 949-5585
Mailing address
PO BOX 936, DUNLAP, TN 37327-0936
(423) 949-5599
(423) 949-5585
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1810
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4074923
BCBST #
TN
01
—
7003292
AETNA PROVIDER #
TN
Enumeration date
11/24/2006
Last updated
07/08/2007
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