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1790356442
JACOB LONG
GREENVILLE, SC
NPI
1790356442
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: SC LL89833)
Enumeration Date
2021-07-04
Last Update Date
2023-06-28
Business Address
JACOB LONG
701 GROVE RD
GREENVILLE, SC 29605-4210
Phone number: 864-455-7895
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Mailing Address
JACOB LONG
701 GROVE RD
GREENVILLE, SC 29605-4210
Phone number: 864-455-7895
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