KEITH EUGENE LONG

MADRAS, OR
NPI1467407122
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA00386)
Enumeration Date2006-05-23
Last Update Date2007-07-09
Business Address
Mr. KEITH EUGENE LONG PA-C
76 NE 12TH ST
MADRAS, OR 97741-1827
Phone number: 541-475-3874
Mailing Address
Mr. KEITH EUGENE LONG PA-C
76 NE 12TH ST
MADRAS, OR 97741-1827
Phone number: 541-475-3874
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