ALICA LONG

GILLETTE, WY
NPI1659385813
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy231H00000X Audiologist
(Licence: WY  A-973)
Additional Taxonomies237600000X Audiologist-Hearing Aid Fitter
(Licence: WY  A-973)
Enumeration Date2006-07-27
Last Update Date2012-09-14
Business Address
-- ALICA LONG M.A. CCC-A
300 GREEN AVE.
GILLETTE, WY 82716-4045
Phone number: 307-689-3611
Mailing Address
-- ALICA LONG M.A. CCC-A
300 GREEN AVE.
GILLETTE, WY 82716-4045
Phone number: 307-689-3611