Individual
CHRISTINE MARIE LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2987 DISTRICT AVE STE 120, FAIRFAX, VA 22031-1571
(888) 663-6331
(415) 252-7176
Mailing address
697 LOUISIANA RD, DYESS AFB, TX 79607-1141
(325) 696-4677
(325) 696-3320
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
1946
NE
207Q00000X
Family Medicine Physician
Primary
0102208415
VA
207Q00000X
Family Medicine Physician
7934
NE
Other
Enumeration date
06/20/2017
Last updated
03/17/2025
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