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1720310147
JACQUI LONG
CHARLOTTE, NC
NPI
1720310147
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NC 10443)
Enumeration Date
2010-02-10
Last Update Date
2016-10-14
Business Address
JACQUI LONG MSOTR/L
1915 RANDOLPH RD
CHARLOTTE, NC 28207-1101
Phone number: 704-323-2248
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Mailing Address
JACQUI LONG MSOTR/L
4601 PARK RD STE 300
CHARLOTTE, NC 28209-2290
Phone number: 704-323-2276
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