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1508957838
MATT LONG
JACKSON, TN
NPI
1508957838
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2006-09-28
Last Update Date
2007-07-09
Business Address
-- MATT LONG B.A.
45 EXECUTIVE DR
JACKSON, TN 38305-2337
Phone number: 731-664-2083
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Mailing Address
-- MATT LONG B.A.
45 EXECUTIVE DR
JACKSON, TN 38305-2337
Phone number: 731-664-2083
Copy
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