Drjerry W Long Optometry

NPI #1013305721 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1013305721
Entity Type: Organization
Organization Name: Drjerry W Long Optometry
Primary Specialty: Optometrist
Enumeration Date: Jan 5, 2015
Last Updated: Jan 5, 2015

Practice Location

Address: 213 N BROADWAY ST
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-5135
Phone: (573) 785-8476

Authorized Official

Name: DR. JERRY W LONG, OD
Title: OWNER
Phone: (573) 785-8476

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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