Provider Demographics
NPI:1740329820
Name:LANG, ROBERT T (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:LANG
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 1:113 S STATE AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2844
Mailing Address - Country:US
Mailing Address - Phone:989-356-0311
Mailing Address - Fax:
Practice Address - Street 1:113 S STATE AVE
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-2844
Practice Address - Country:US
Practice Address - Phone:989-356-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95OZ410250OtherBCBS OF MI
MI95OZ410250OtherBCBS OF MI
MI0P59140Medicare PIN