MICHAEL THOMAS LONG

IDAHO FALLS, ID
NPI1063114742
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-03-20
Last Update Date2023-03-20
Business Address
MICHAEL THOMAS LONG DO
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number: 208-973-2144
Mailing Address
MICHAEL THOMAS LONG DO
3100 CHANNING WAY
IDAHO FALLS, ID 83404-7533
Phone number:
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