Individual
KRISTINA M LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704323417
MI
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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