MEDICARE: DR. JASON LANGHOUGH DC, DACNB

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	111NN0400X	Neurology Chiropractor	X012879-1	NY
2	111NN0400X	Neurology Chiropractor	5408	NC

General Provider Information

NPI Number	:	1740707157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON LANGHOUGH DC, DACNB

Provider Business Mailing Address
First Line	:	190 FROEHLICH FARM BLVD
Second Line	:
City	:	WOODBURY
State	:	NY
Zip	:	11797-2905
Country	:	US
Telephone Number	:	516-513-1490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1895 N NC 16 BUSINESS HWY
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-8642
Country	:	US
Telephone Number	:	704-489-2273
Fax Number	:

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

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	09/29/2023

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