Provider Demographics
NPI:1134480759
Name:LONG, ALLISON M (DC)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:LONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-1092
Mailing Address - Country:US
Mailing Address - Phone:580-338-2464
Mailing Address - Fax:580-338-1477
Practice Address - Street 1:14214 HIGHWAY 3 STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1617
Practice Address - Country:US
Practice Address - Phone:832-240-4319
Practice Address - Fax:281-754-4270
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4072111N00000X
TX12759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor