Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 038011517 | IL |
N | 111NS0005X | Chiropractic Sports Physician | 038011517 | IL |
NPI | 1275867236 |
---|---|
Provider Name | Arthur Langston |
First Address | Troy, IL 62294-1336 |
Second Address | Troy, IL 62294-1336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2009 |
Last Update Date | 17/11/2015 |