| Long Chiropractic Inc | |
|
307 E Karsch Blvd Ste E Farmington MO 63640-1768 | |
| (573) 760-1515 | |
| (573) 760-0817 |
| Full Name | Long Chiropractic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 307 E Karsch Blvd, Farmington, Missouri |
| Authorized Official Name and Position | Lisa Renee Long (DOCTOR OF CHIROPRACTIC) |
| Authorized Official Contact | 5737601515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Chiropractic Inc 307 East Karsch Blvd Ste E Farmington MO 63640-1203 Ph: (573) 760-1515 | Long Chiropractic Inc 307 E Karsch Blvd Ste E Farmington MO 63640-1768 Ph: (573) 760-1515 |
| NPI Number | 1528288693 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 08/11/2011 |
| Medicare PECOS PAC ID | 0244411536 |
|---|---|
| Medicare Enrollment ID | O20110218000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528288693 | NPI | - | NPPES |
| 105957 | Other | MO | BCBS OF MO |
| 10410T002 | Other | MO | COVENTRY HEALTH |
| T2448 | Other | MO | MERCY HEALTH PLANS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5812 (Missouri) | Primary |
| Provider Name | Lisa R Long |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104818731 PECOS PAC ID: 3870774169 Enrollment ID: I20110218000853 |
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