Provider Demographics
NPI:1821504622
Name:LONG, NOEMIE (DC)
Entity Type:Individual
Prefix:DR
First Name:NOEMIE
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6406 MCCRIMMON PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8145
Mailing Address - Country:US
Mailing Address - Phone:919-446-3705
Mailing Address - Fax:
Practice Address - Street 1:6406 MCCRIMMON PKWY STE 230
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8145
Practice Address - Country:US
Practice Address - Phone:919-446-3705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-17
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013029111N00000X
PAAJ011070111N00000X
NJ38MC00752900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor