1679571707 NPI number — LANGSTROTH CHIROPRACTIC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679571707 NPI number — LANGSTROTH CHIROPRACTIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LANGSTROTH CHIROPRACTIC, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679571707
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1765 CHALLENGE WAY
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95815-5000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-925-2007
Provider Business Mailing Address Fax Number:
916-925-0736

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1765 CHALLENGE WAY
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95815-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-925-2007
Provider Business Practice Location Address Fax Number:
916-925-0736
Provider Enumeration Date:
07/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LANGSTROTH
Authorized Official First Name:
KIT
Authorized Official Middle Name:
THOMAS
Authorized Official Title or Position:
OWNER / DOCTOR OF CHIROPRACTIC
Authorized Official Telephone Number:
916-925-2007

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  17733 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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