Provider Demographics
NPI:1134699127
Name:LANGEBARTELS, TAYLOR ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:ANDREW
Last Name:LANGEBARTELS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19107 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-7215
Mailing Address - Country:US
Mailing Address - Phone:918-633-5531
Mailing Address - Fax:
Practice Address - Street 1:19107 E 49TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-7215
Practice Address - Country:US
Practice Address - Phone:918-633-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4306111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty