Theresa Adele Long

NPI #1962836379 in Logan, Ohio

Provider Information

NPI Number
1962836379
Entity Type
Individual
Name
Theresa Adele Long
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Licensed Practical Nurse
Enumeration Date
Aug 22, 2013
Last Updated
Aug 22, 2013

Practice Location

Address
10099 WEBB RD
City
Logan
State
Ohio
ZIP Code
43138-8450
Phone
(740) 583-0772

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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