Individual
JENNIFER LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4750 E 450 S, WHITESTOWN, IN 46075-8404
(877) 732-3431
Mailing address
105 N PARK AVE, ALEXANDRIA, IN 46001-2055
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024063A
IN
Other
Enumeration date
07/18/2019
Last updated
06/28/2023
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