ROBERT WAYNE LONG

ST CHARLES, IL
NPI1083985154
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036-075581)
Enumeration Date2012-01-22
Last Update Date2012-01-22
Business Address
-- ROBERT WAYNE LONG D.O.
525 TYLER RD
ST CHARLES, IL 60174-3305
Phone number: 630-584-2070
Mailing Address
-- ROBERT WAYNE LONG D.O.
525 TYLER RD
ST CHARLES, IL 60174-3305
Phone number: 630-584-2070
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