BRIAN J LONG

KINGMAN, AZ
NPI1508577800
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YP1600X Counselor, Pastoral
(Licence: AZ  22972)
Enumeration Date2022-12-07
Last Update Date2022-12-07
Business Address
BRIAN J LONG BA
1850 GATES AVE
KINGMAN, AZ 86401-8003
Phone number: 928-377-0453
Mailing Address
BRIAN J LONG BA
4085 N VAN NUYS RD
KINGMAN, AZ 86409-2544
Phone number: 928-377-0453
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