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1396438974
MALLORY BREANNE LONG
JONESBORO, AR
NPI
1396438974
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: AR 5281)
Enumeration Date
2023-05-31
Last Update Date
2023-05-31
Business Address
Ms. MALLORY BREANNE LONG DPT
1107 E MATTHEWS AVE STE 100
JONESBORO, AR 72401-4331
Phone number: 870-933-6393
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Mailing Address
Ms. MALLORY BREANNE LONG DPT
1107 E MATTHEWS AVE STE 100
JONESBORO, AR 72401-4331
Phone number: 870-933-6393
Copy
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