Provider Demographics
NPI:1891354924
Name:LANGEBARTELS CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:LANGEBARTELS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DC
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LANGEBARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-633-5531
Mailing Address - Street 1:500 S ELM PL STE B
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-5376
Mailing Address - Country:US
Mailing Address - Phone:918-633-5531
Mailing Address - Fax:
Practice Address - Street 1:500 S ELM PL STE B
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5376
Practice Address - Country:US
Practice Address - Phone:918-633-5531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty