JUSTIN WAYNE LONG

DACULA, GA
NPI1184728263
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: GA  PT008689)
Enumeration Date2006-09-11
Last Update Date2007-07-08
Business Address
Mr. JUSTIN WAYNE LONG MPT
2085 HAMILTON CREEK PKWY SUITE 160
DACULA, GA 30019
Phone number: 770-271-1488
Mailing Address
Mr. JUSTIN WAYNE LONG MPT
1013 SABLE CROSSING
SUWANEE, GA 30024
Phone number: 417-234-9856
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