Lagrange Clinic Of Chiropractic Incorporated | |
403 Ridley Ave, Lagrange, GA 30240-2231 | |
(706) 882-1000 | |
Not Available |
Full Name | Lagrange Clinic Of Chiropractic Incorporated |
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Type | Facility |
Speciality | Chiropractor |
Location | 403 Ridley Ave, Lagrange, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1346452596 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | CHIR007612 (Georgia) | Primary |
Provider Name | Stephan M Langston |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1669436416 PECOS PAC ID: 3577503481 Enrollment ID: I20050517000264 |
Mailing Address | Practice Location Address |
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Lagrange Clinic Of Chiropractic Incorporated Po Box 1010, Lagrange, GA 30241-0018 Ph: (706) 882-1000 | Lagrange Clinic Of Chiropractic Incorporated 403 Ridley Ave, Lagrange, GA 30240-2231 Ph: (706) 882-1000 |
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