Provider Demographics
NPI:1427128180
Name:LANGENBERG CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:LANGENBERG CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANGENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-869-3888
Mailing Address - Street 1:711 W SUNSHINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2439
Mailing Address - Country:US
Mailing Address - Phone:417-869-3888
Mailing Address - Fax:417-869-5575
Practice Address - Street 1:711 W SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-2439
Practice Address - Country:US
Practice Address - Phone:417-869-3888
Practice Address - Fax:417-869-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO211709OtherBLUE CROSS BLUE SHIELD
MO211709OtherBLUE CHOICE
MO105961OtherBLUE CROSS BLUE SHIELD
MO105961OtherBLUE CHOICE
MO000431535596OtherPREMIER HEALTH PLANS
MO4411550OtherUNITED HEALTHCARE
MO105961OtherBLUE CROSS BLUE SHIELD
MO4411550OtherUNITED HEALTHCARE