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JACKY RAY LANGSTON DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1033107545

Individual Registrant:
 JACKY RAY LANGSTON DC
Gender: M
Sole Proprietor

Location and contact information for practice:
115 E 5TH ST  TUSCUMBIA, AL 35674-2409 US
Tel: 256-383-6238  Fax: 256-383-6234

Contact information for business:
PO BOX 256  TUSCUMBIA, AL 35674-0256 US
Tel: 256-383-6238  Fax: 256-383-6234

Registration Information:
NPI: 1033107545
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
AL744

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BC/BS51002591AL01
AETNA51073375AL01




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