=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609836832
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GERALD ANDREW LANGLEY D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2006
-----------------------------------------------------
Last Update Date | 03/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2905 N OAKWOOD AVE
-----------------------------------------------------
City | MUNCIE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47304-2255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-254-1270
-----------------------------------------------------
Fax | 765-254-1271
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2905 N OAKWOOD AVE
-----------------------------------------------------
City | MUNCIE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47304-2255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-254-1270
-----------------------------------------------------
Fax | 765-254-1271
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 08001391A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 81000031A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------