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Individual
EMMA MARIE LONG
Active
Individual
EMMA MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1380075
—
LA
Enumeration date
07/02/2008
Last updated
02/08/2012
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