Provider Demographics
NPI:1467225128
Name:ROBIN S LONG CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:ROBIN S LONG CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:STACY
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-244-7947
Mailing Address - Street 1:706 VALLEY MILLS DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4772
Mailing Address - Country:US
Mailing Address - Phone:469-269-5477
Mailing Address - Fax:
Practice Address - Street 1:10611 GARLAND RD STE 115
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-2694
Practice Address - Country:US
Practice Address - Phone:469-269-5477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty