Daniel Long

NPI #1972686194 in Madisonville, Tennessee

Provider Information

NPI Number: 1972686194
Entity Type: Organization
Organization Name: Daniel Long
Primary Specialty: Specialist
Enumeration Date: Oct 23, 2006
Last Updated: Jun 11, 2008

Practice Location

Address: 520 COOK ST
Address 2: SUITE D
City: Madisonville
State: Tennessee
ZIP Code: 37354-1508
Phone: (423) 442-1440

Authorized Official

Name: MR. DANIEL EVERETT LONG, P.T.
Title: OWNER
Phone: (423) 442-1440

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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