RICHARD LONGSTREET

TAMPA, FL
NPI1669169918
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QD1600X Clinic/Center, Developmental Disabilities
Enumeration Date2023-04-18
Last Update Date2023-04-18
Business Address
RICHARD LONGSTREET
7369 BONITA VISTA WAY APT 202
TAMPA, FL 33617-8697
Phone number: 813-765-4080
Mailing Address
RICHARD LONGSTREET
7369 BONITA VISTA WAY APT 202
TAMPA, FL 33617-8697
Phone number: 813-765-4080