MADONNA ELIZABETH MARIE LONG

KEMMERER, WY
NPI1023600723
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2021-02-04
Last Update Date2021-02-04
Business Address
MADONNA ELIZABETH MARIE LONG
806 PINE AVE
KEMMERER, WY 83101-2900
Phone number: 307-877-2993
Mailing Address
MADONNA ELIZABETH MARIE LONG
PO BOX 1074
KEMMERER, WY 83101-1074
Phone number: 307-877-2993
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