Individual
VIOLET MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
4100 LOUISIANA AVENUE, LAKE CHARLES, LA 70607
(337) 439-9306
(337) 310-4042
Mailing address
4100 LOUISIANA AVENUE, LAKE CHARLES, LA 70607
(337) 439-9306
(337) 310-4042
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
744
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1935913
—
LA
Enumeration date
09/13/2006
Last updated
07/08/2007
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