Provider Demographics
NPI:1407865561
Name:LANGSTON, PERRY VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:VINCENT
Last Name:LANGSTON
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 1:4309 S RACKET DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-2257
Mailing Address - Country:US
Mailing Address - Phone:605-332-9235
Mailing Address - Fax:605-332-6642
Practice Address - Street 1:4309 S RACKET DR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-2257
Practice Address - Country:US
Practice Address - Phone:605-332-9235
Practice Address - Fax:605-332-2261
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1202111N00000X
SD1126111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor