MR. Jerry Lee Long JR.
NPI #1881240349 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1881240349
- Entity Type
- Individual
- Name
- MR. Jerry Lee Long JR.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Customized Equipment
- Enumeration Date
- Aug 12, 2019
- Last Updated
- Aug 12, 2019
Practice Location
- Address
- 6654 BITTEROOT LN
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63134-1451
- Phone
- (813) 494-1282
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
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