Provider Demographics
NPI:1366468340
Name:LANGFORD, CHRISTIAN VAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:VAN
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:CHRISTIANN
Other - Middle Name:IVAN ALEXIS
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 EAST TUDOR ROAD
Mailing Address - Street 2:STE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-222-2100
Mailing Address - Fax:907-222-2131
Practice Address - Street 1:550 EAST TUDOR ROAD
Practice Address - Street 2:STE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-222-2100
Practice Address - Fax:907-222-2131
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH4949Medicaid
AKCH4949Medicaid
153022Medicare ID - Type Unspecified