Individual
MR. EVAN CHRISTOPHER LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5755 N STATE ROAD 9, HOWE, IN 46746-9228
(765) 543-1367
Mailing address
1265 N 170 W, ANGOLA, IN 46703-9416
(765) 543-1367
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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