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General NPI Number Information
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NPI Number | 1790059418
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Entity Type | Organization
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Legal Business Name | LONG FAMILY CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 604 N THORNTON AVE
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City | ORLANDO
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State | FL
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Zip | 32803-4634
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Country | US
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Telephone | 407-425-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 604 N THORNTON AVE
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City | ORLANDO
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State | FL
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Zip | 32803-4634
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Country | US
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Telephone | 407-425-3555
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. YEN K NGUYEN
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Credential | D.C.
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Telephone | 407-425-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CH8154
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License Number State | FL
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