MR. Kenneth D Long

NPI #1982605911 in Prineville, Oregon

Provider Information

NPI Number: 1982605911
Entity Type: Individual
Name: MR. Kenneth D Long
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Physician Assistant
Enumeration Date: Aug 1, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 1251 NE ELM ST
City: Prineville
State: Oregon
ZIP Code: 97754
Phone: (541) 447-1680

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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