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1144295197
JERRY WAYNE LONG
POPLAR BLUFF, MO
NPI
1144295197
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: MO T02229)
Enumeration Date
2006-02-22
Last Update Date
2014-07-03
Business Address
Dr. JERRY WAYNE LONG O.D
213 N BROADWAY ST
POPLAR BLUFF, MO 63901-5135
Phone number: 573-785-8476
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Mailing Address
Dr. JERRY WAYNE LONG O.D
213 N BROADWAY ST
POPLAR BLUFF, MO 63901-5135
Phone number: 573-785-8476
Copy
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