VINCE LONG

SHAWANO, WI
NPI1881356822
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  16456-131)
Enumeration Date2021-10-07
Last Update Date2021-10-07
Business Address
VINCE LONG SAC
100 COUNTY ROAD B
SHAWANO, WI 54166-7072
Phone number: 715-524-2161
Mailing Address
VINCE LONG SAC
100 COUNTY ROAD B
SHAWANO, WI 54166-7072
Phone number:
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