Individual
TIMOTHY LANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 S 1ST ST, LONG GROVE, IA 52756-8721
(563) 370-3097
Mailing address
307 S 1ST ST, LONG GROVE, IA 52756-8721
(563) 370-3097
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
778AA3540
IA
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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