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1962836379
THERESA ADELE LONG
LOGAN, OH
NPI
1962836379
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OH PN089455)
Enumeration Date
2013-08-22
Last Update Date
2013-08-22
Business Address
-- THERESA ADELE LONG
10099 WEBB RD
LOGAN, OH 43138-8450
Phone number: 740-583-0772
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Mailing Address
-- THERESA ADELE LONG
10099 WEBB RD
LOGAN, OH 43138-8450
Phone number: 740-583-0772
Copy
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