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Individual

DR. BRENTON D DELONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D,C,

Contact information

Practice address
1018 24TH AVE NW STE 100, NORMAN, OK 73069-6543
(563) 271-4095
Mailing address
629 W 4TH ST, LAMONI, IA 50140-1209
(563) 271-4095

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3991
OK

Other

Enumeration date
11/01/2010
Last updated
11/01/2010
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