NATHANAEL JAMES LONGACRE

ODESSA, TX
NPI1801406954
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA14987)
Enumeration Date2020-08-04
Last Update Date2021-10-12
Business Address
NATHANAEL JAMES LONGACRE
519 N LINCOLN AVE
ODESSA, TX 79761-4429
Phone number: 432-640-6446
Mailing Address
NATHANAEL JAMES LONGACRE
PO BOX 2129
ODESSA, TX 79760-2129
Phone number: 432-640-2408
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