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1356663991
MICHELLE BLACKWELL LONG
LAKELAND, FL
NPI
1356663991
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Former Name
MICHELLE BLACKWELL CARDOSI
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PT0025201)
Enumeration Date
2010-02-24
Last Update Date
2010-02-24
Business Address
Ms. MICHELLE BLACKWELL LONG P.T.
4406 S FLORIDA AVE SUITE #16
LAKELAND, FL 33813-2172
Phone number: 863-688-1800
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Mailing Address
Ms. MICHELLE BLACKWELL LONG P.T.
4406 S FLORIDA AVE SUITE #16
LAKELAND, FL 33813-2172
Phone number: 863-688-1800
Copy
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