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1114743002
BETHANY LONG
DETROIT, MI
NPI
1114743002
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-11-25
Last Update Date
2024-11-25
Business Address
BETHANY LONG
259 MACK AVE
DETROIT, MI 48201-2427
Phone number: 313-577-1716
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Mailing Address
BETHANY LONG
259 MACK AVE STE 2590
DETROIT, MI 48201-2427
Phone number: 313-577-1716
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