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General NPI Number Information
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NPI Number | 1417389438
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Entity Type | Organization
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Legal Business Name | BRENT DELONG, PLLC
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 1018 24TH AVE NW SUITE 100
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City | NORMAN
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State | OK
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Zip | 73069-6543
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Country | US
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Telephone | 405-701-5345
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Fax | 405-701-5346
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Provider Business Mailing Address
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Address Line | 1018 24TH AVE NW SUITE 100
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City | NORMAN
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State | OK
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Zip | 73069-6543
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Country | US
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Telephone | 405-701-5345
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Fax | 405-701-5346
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Authorized Official
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Title or Position | PARTNER
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Name | DR. BRENT DELONG
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Credential | D.C.
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Telephone | 405-701-5345
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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 | 4126
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License Number State | OK
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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 | 3991
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License Number State | OK
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