SHANNON FRESHWATER LONG

FE WARREN AFB, WY
NPI1588111090
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2016-09-01
Last Update Date2022-10-26
Business Address
Mrs. SHANNON FRESHWATER LONG PA-C
6900 ALDEN DR
FE WARREN AFB, WY 82005-2945
Phone number: 307-773-3435
Mailing Address
Mrs. SHANNON FRESHWATER LONG PA-C
UNIT 3215
APO, AE 09094-3215
Phone number: 314-479-2049
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