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General NPI Number Information
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NPI Number | 1265990501
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Entity Type | Individual
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Provider Name | JENNIFER LONG DC
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Gender | Female
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 1820 S WESTNEDGE AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008-1998
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Country | US
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Telephone | 386-478-6982
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Fax |
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Provider Business Mailing Address
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Address Line | 366 BOYER CT
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City | MARSHALL
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State | MI
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Zip | 49068-1197
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH12737
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301401548
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License Number State | MI
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