| NPI | 1346430915 |
|---|---|
| Professional Name | LISA RENEE LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1099182) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1099182) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-08-31 |