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1861918534
JACK LONG
WALTHAM, MA
NPI
1861918534
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MA 23177)
Enumeration Date
2017-08-15
Last Update Date
2022-01-25
Business Address
JACK LONG DPT
425 WAVERLEY OAKS RD
WALTHAM, MA 02452-8448
Phone number: 781-373-3620
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Mailing Address
JACK LONG DPT
10 LIBERTY SQ BSMT 1
BOSTON, MA 02109-5814
Phone number: 617-536-1161
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