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1003553637
SUSIE JANE LONG
FAIRMONT, WV
NPI
1003553637
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2022-05-16
Last Update Date
2022-05-16
Business Address
SUSIE JANE LONG
16 MOUNTAIN PARK DR
FAIRMONT, WV 26554-8992
Phone number: 304-816-3687
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Mailing Address
SUSIE JANE LONG
16 MOUNTAIN PARK DR
FAIRMONT, WV 26554-8992
Phone number: 304-816-3687
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