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Individual

DR. CHAD EVERETT LONGFELLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
306 E HIGH ST, MOUNT VERNON, OH 43050-3420
(740) 392-4878
(740) 392-6894
Mailing address
306 E HIGH ST, MOUNT VERNON, OH 43050-3420
(740) 392-4878
(740) 392-6894

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1575
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000503889
ANTHEM PROVIDER #
OH
05
2719133
OH
Enumeration date
06/29/2006
Last updated
11/24/2009
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