Organization
DAVID R. LONG D.C. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R LONG D.C. (OWNER)
(208) 736-1976
Entity
Organization
Contact information
Practice address
497 EASTLAND DR, TWIN FALLS, ID 83301-7441
(208) 736-1976
(208) 736-1986
Mailing address
497 EASTLAND DR, TWIN FALLS, ID 83301-7441
(208) 736-1976
(208) 736-1986
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-621
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010020543
BLUE SHIELD
—
01
—
C6210
BLUE CROSS
—
Enumeration date
08/13/2008
Last updated
11/12/2008
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