CARL EDWARD LONG

JACKSONVILLE, FL
NPI1871564815
Entity TypeIndividual
GenderMale
Sole Proprietor ?
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence:   1053572)
Enumeration Date2006-01-28
Last Update Date2007-07-08
Business Address
MR. CARL EDWARD LONG PA-C
2080 CHILD ST
JACKSONVILLE, FL 32214-5005
Phone number: 912-573-4267
Mailing Address
MR. CARL EDWARD LONG PA-C
1012 DRAKE FEATHER DR
ORANGE PARK, FL 32065-5209
Phone number: 904-625-7395