Individual
CHRISTIAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
WATERTOWN REGIONAL MEDICAL CENTER, 1684 S CHURCH ST, WATERTOWN, WI 53094
(920) 262-4220
Mailing address
801 SCHULTZ PL, MONONA, WI 53716-2013
(608) 514-6102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11437-24
WI
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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