DR. Jack A Long, D.C.

NPI #1184792129 in Meridian, Idaho

Provider Information

NPI Number
1184792129
Entity Type
Individual
Name
DR. Jack A Long, D.C.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Chiropractor
Credential
D.C.
Enumeration Date
Nov 30, 2006
Last Updated
Jul 9, 2007

Practice Location

Address
2893 E GREEN CANYON DR
State
Idaho
ZIP Code
83642-9105
Phone
(208) 850-6511

Specialties & Taxonomy Codes

Specialty
Chiropractor

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