TRAVIS DAVID LONG

DAYTONA BEACH, FL
NPI1104262781
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA9107114)
Enumeration Date2013-05-22
Last Update Date2016-03-03
Business Address
-- TRAVIS DAVID LONG PA
303 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114-2709
Phone number: 386-254-4000
Mailing Address
-- TRAVIS DAVID LONG PA
PO BOX 732901
DALLAS, TX 75373-2901
Phone number: 386-226-4590