JACK A LONG

MERIDIAN, ID
NPI1184792129
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy111N00000X Chiropractor
(Licence: ID  Chia-352)
Enumeration Date2006-11-30
Last Update Date2007-07-09
Business Address
Dr. JACK A LONG D.C.
2893 E GREEN CANYON DR
MERIDIAN, ID 83642-9105
Phone number: 208-850-6511
Mailing Address
Dr. JACK A LONG D.C.
2893 E GREEN CANYON DR
MERIDIAN, ID 83642-9105
Phone number: 208-850-6511
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