MEDICARE: AVA KATHRYN LANGFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3903	TN

General Provider Information

NPI Number	:	1700771771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVA KATHRYN LANGFORD

Provider Business Mailing Address
First Line	:	7127 CROSSROADS BLVD STE 104
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2827
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7127 CROSSROADS BLVD STE 104
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2827
Country	:	US
Telephone Number	:	563-676-3164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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Directions to “ AVA KATHRYN LANGFORD ” Practice Location

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