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1104554195
ELIJAH LONG
AUGUSTA, GA
NPI
1104554195
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: GA PT016046)
Enumeration Date
2022-08-09
Last Update Date
2022-08-09
Business Address
ELIJAH LONG DPT
254 ROBERT C DANIEL JR PKWY STE 4B
AUGUSTA, GA 30909-0812
Phone number: 706-723-5795
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Mailing Address
ELIJAH LONG DPT
1200 CORPORATE DR STE 400
HOOVER, AL 35242-5424
Phone number: 423-541-3263
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