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Individual

KELLY MARIE LANGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
108 E HERSEY ST, # 2, ASHLAND, OR 97520-1363
(541) 482-3492
(541) 482-4203
Mailing address
382 CHERRY LN, ASHLAND, OR 97520-1502
(541) 301-4200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3497
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
233002
OR
Enumeration date
07/21/2006
Last updated
09/14/2017
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