Individual
DEBRA S LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.T.(R)(T)
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-3011
Mailing address
8920 PRAIRIE TRL, AVON, IN 46123-9084
(317) 988-3011
Taxonomy
Speciality
Code
Description
License number
State
2471R0002X
Radiation Therapy Radiologic Technologist
Primary
171509
IN
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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