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1982102885
BENJAMIN C LONG
JOPLIN, MO
NPI
1982102885
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MO 2018002044)
Enumeration Date
2018-01-25
Last Update Date
2018-01-25
Business Address
BENJAMIN C LONG
3105 MCCLELLAND BLVD.
JOPLIN, MO 64804
Phone number: 417-347-5400
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Mailing Address
BENJAMIN C LONG
3105 MCCLELLAND BLVD.
JOPLIN, MO 64804
Phone number: 417-347-5400
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