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General NPI Number Information
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NPI Number | 1275709156
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Entity Type | Organization
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Legal Business Name | STANMORE G LANGFORD III DC A CHIROPRACTIC PROF CORPORATION
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 4360 MAIN STREET STE 209
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City | CHULA VISTA
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State | CA
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Zip | 91911-6575
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Country | US
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Telephone | 619-585-3611
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Fax | 619-585-3469
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Provider Business Mailing Address
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Address Line | 4360 MAIN STREET STE 209
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City | CHULA VISTA
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State | CA
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Zip | 91911-6575
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Country | US
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Telephone | 619-585-3611
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Fax | 619-585-3469
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANMORE GEORGE LANGFORD III
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Credential | DC
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Telephone | 619-585-3611
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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 | DC16687
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License Number State | CA
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