KENNETH D LONG

PRINEVILLE, OR
NPI1982605911
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA00535)
Enumeration Date2005-08-01
Last Update Date2007-07-08
Business Address
Mr. KENNETH D LONG
1251 NE ELM ST
PRINEVILLE, OR 97754
Phone number: 541-447-1680
Mailing Address
Mr. KENNETH D LONG
1251 NE ELM ST
PRINEVILLE, OR 97754
Phone number: 541-447-1680
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