MICHAEL THOMAS LONG

IDAHO FALLS, ID
NPI1063114742
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: ID  7771476)
Enumeration Date2023-03-20
Last Update Date2026-07-02
Business Address
MICHAEL THOMAS LONG DO
2265 DESOTO ST
IDAHO FALLS, ID 83404-7540
Phone number: 208-569-7139
Mailing Address
MICHAEL THOMAS LONG DO
2265 DESOTO ST
IDAHO FALLS, ID 83404-7540
Phone number: 208-569-7139
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