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1013638204
DALE ALLAN LONG
FAIRMONT, WV
NPI
1013638204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2022-09-07
Last Update Date
2022-09-07
Business Address
DALE ALLAN LONG
53 DOE RUN RD
FAIRMONT, WV 26554-2091
Phone number: 304-612-1662
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Mailing Address
DALE ALLAN LONG
53 DOE RUN RD
FAIRMONT, WV 26554-2091
Phone number: 304-612-1662
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