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Organization

LONG CHIROPRACTIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LISA RENEE LONG DC (DOCTOR OF CHIROPRACTIC)
(573) 760-1515
Entity
Organization

Contact information

Practice address
307 E KARSCH BLVD, STE E, FARMINGTON, MO 63640-1768
(573) 760-1515
(573) 760-0817
Mailing address
307 EAST KARSCH BLVD, STE E, FARMINGTON, MO 63640-1203
(573) 760-1515
(573) 760-0817

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5812
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10410T002
COVENTRY HEALTH
MO
01
105957
BCBS OF MO
MO
01
T2448
MERCY HEALTH PLANS
MO
Enumeration date
04/30/2007
Last updated
08/11/2011
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