Provider Demographics
NPI:1184861072
Name:LONG, CHRISTOPHER J (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:LONG
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 1:101 DOC HENRY RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-9774
Mailing Address - Country:US
Mailing Address - Phone:816-537-5995
Mailing Address - Fax:866-591-2698
Practice Address - Street 1:101 DOC HENRY RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MO
Practice Address - Zip Code:64034-9774
Practice Address - Country:US
Practice Address - Phone:816-537-5995
Practice Address - Fax:866-591-2698
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002007704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor