Individual
VINCENT B LONGOBARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
19 MIRACLE LN, SUITE 200, CROSSVILLE, TN 38555-7654
(931) 707-8352
(931) 707-8053
Mailing address
PO BOX 8, CROSSVILLE, TN 38557-0008
(931) 707-8352
(931) 707-8053
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
DPM0000000520
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3352893
—
TN
Enumeration date
10/05/2005
Last updated
09/27/2013
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