LANCE P LONGO

WAUWATOSA, WI
NPI1356458806
Other NameLANCE PETER LONGO
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WI  37822)
Additional Taxonomies2084P0802X Psychiatry & Neurology, Addiction Psychiatry
(Licence: MA  74570)
Enumeration Date2006-08-23
Last Update Date2024-09-18
Business Address
Dr. LANCE P LONGO MD
1220 DEWEY AVE
WAUWATOSA, WI 53213-2598
Phone number: 414-773-4311
Mailing Address
Dr. LANCE P LONGO MD
PO BOX 735044
CHICAGO, IL 60673-5044
Phone number: 800-326-2250