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Individual

DR. TYSON BENJAMIN LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1096 EASTLAND DR N STE 300, TWIN FALLS, ID 83301-8970
(208) 537-7246
Mailing address
1096 EASTLAND DR N STE 300, TWIN FALLS, ID 83301-8970
(208) 537-7246

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1916
ID

Other

Enumeration date
04/01/2019
Last updated
04/01/2019
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