Provider Demographics
NPI:1174785125
Name:LANG FAMILY CHIROPRACTIC L.L.C.
Entity type:Organization
Organization Name:LANG FAMILY CHIROPRACTIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-356-0311
Mailing Address - Street 1:113 S STATE AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2844
Mailing Address - Country:US
Mailing Address - Phone:989-356-0311
Mailing Address - Fax:
Practice Address - Street 1:113 S STATE AVE
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-2844
Practice Address - Country:US
Practice Address - Phone:989-356-0311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950Z410250OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI0P59140Medicare PIN
MIU50843Medicare UPIN