JACK LONG

CAMBRIDGE, MA
NPI1861918534
Former NameJACK DOUCETTE-LONG
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: MA  23177)
Enumeration Date2017-08-15
Last Update Date2025-10-14
Business Address
JACK LONG DPT
356 THIRD ST
CAMBRIDGE, MA 02142-1111
Phone number: 617-714-5402
Mailing Address
JACK LONG DPT
4 RICHMOND SQ
PROVIDENCE, RI 02906-5117
Phone number: 401-433-4172