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Individual

DORANNE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., P.T.

Contact information

Practice address
544 UNION AVE, GRANTS PASS, OR 97527-5544
(541) 955-0940
(541) 955-5233
Mailing address
1005 SHARON DR, GRANTS PASS, OR 97527-8746
(541) 474-3527

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1086
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
050927
OR
01
R102653
GROUP MEDICARE
OR
Enumeration date
12/15/2005
Last updated
07/08/2007
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