| NPI | 1831475839 |
|---|---|
| Former Name | MARIA L LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY 1392) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2016-12-30 |