JACOB LONG

GREENVILLE, SC
NPI1790356442
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: SC  LL89833)
Enumeration Date2021-07-04
Last Update Date2023-06-28
Business Address
JACOB LONG
701 GROVE RD
GREENVILLE, SC 29605-4210
Phone number: 864-455-7895
Mailing Address
JACOB LONG
701 GROVE RD
GREENVILLE, SC 29605-4210
Phone number: 864-455-7895