JERRY LEE LONG

SAINT LOUIS, MO
NPI1881240349
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment
Enumeration Date2019-08-12
Last Update Date2019-08-12
Business Address
Mr. JERRY LEE LONG
6654 BITTEROOT LN
SAINT LOUIS, MO 63134-1451
Phone number: 813-494-1282
Mailing Address
Mr. JERRY LEE LONG
PO BOX 34086
SAINT LOUIS, MO 63134-0086
Phone number: 813-494-1282
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