Organization
LONG LEGACY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TY BENJAMIN LONG DC (CHIROPRACTOR)
(208) 537-7246
Entity
Organization
Contact information
Practice address
1096 EASTLAND DR N STE 300, TWIN FALLS, ID 83301-8970
(208) 537-7246
Mailing address
1096 EASTLAND DR N STE 300, TWIN FALLS, ID 83301-8970
(208) 537-7246
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
111NS0005X
Sports Physician Chiropractor
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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