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1861460511
COREY THOMAS LONG
SOUTHLAKE, TX
NPI
1861460511
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: TX 1115061)
Enumeration Date
2006-03-09
Last Update Date
2020-02-19
Business Address
Mr. COREY THOMAS LONG PT
731 E SOUTHLAKE BLVD STE 150
SOUTHLAKE, TX 76092-6380
Phone number: 817-442-8600
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Mailing Address
Mr. COREY THOMAS LONG PT
PO BOX 2650
COPPELL, TX 75019-8607
Phone number: 972-724-2400
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