Individual
DR. CHARLES LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2243 S MERIDIAN AVE, SUITE 101, WICHITA, KS 67213-1911
(316) 945-2525
(316) 945-5694
Mailing address
2243 S MERIDIAN AVE, SUITE 101, WICHITA, KS 67213-1911
(316) 945-2525
(316) 945-5694
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
KS01-04041
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062112
BLUE CROSS BLUE SHIELD
KS
01
—
2024
PHS
KS
Enumeration date
06/30/2006
Last updated
09/17/2013
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