Individual
DR. ROBERT D. LONGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
441 BROADWAY, BOX 696, IMPERIAL, NE 69033-0696
(308) 882-5532
Mailing address
441 BROADWAY, BOX 696, IMPERIAL, NE 69033-0696
(308) 882-5532
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
945
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09704
BC/BS OF NEBRASKA
NE
01
—
21-5705010
STATE EMPLOYER (SIN)
NE
01
—
47-0718052
FED. EMPLOYER (FIN)
—
05
—
470718052-00
—
NE
Enumeration date
06/16/2005
Last updated
07/02/2010
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