Provider Demographics
NPI:1124285259
Name:JOHN LANG CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:JOHN LANG CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-283-5070
Mailing Address - Street 1:8459 US 42
Mailing Address - Street 2:SUITE E
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042
Mailing Address - Country:US
Mailing Address - Phone:859-283-5070
Mailing Address - Fax:859-283-5071
Practice Address - Street 1:8459 US 42
Practice Address - Street 2:SUITE E
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-283-5070
Practice Address - Fax:859-283-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK038431Medicare PIN
KYU90170Medicare UPIN