Provider Demographics
NPI:1245364371
Name:LONG'S CHIROPRACTIC HEALTH SERVICES, PC
Entity type:Organization
Organization Name:LONG'S CHIROPRACTIC HEALTH SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVAL-BRANSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MSACN
Authorized Official - Phone:717-394-6558
Mailing Address - Street 1:3141 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4012
Mailing Address - Country:US
Mailing Address - Phone:717-394-6558
Mailing Address - Fax:717-394-6813
Practice Address - Street 1:3141 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-4012
Practice Address - Country:US
Practice Address - Phone:717-394-6558
Practice Address - Fax:717-394-6813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006842-L111N00000X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA413831OtherHEALTH ASSURANCE PROV NO
PALO1819033OtherHIGHMARK PROVIDER NUMBER
PA5476570OtherAETNA PPO PIN
PA3647280OtherAETNA HMO PROV NO
PA2678917000OtherINDEPENDENCE BLUE CROSS
PA5476570OtherAETNA PPO PIN
PAU63694Medicare UPIN