Individual
MS. STACY MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
G-3100 VAN SLYKE, FLINT, MI 48551-0001
(810) 835-0068
(810) 835-0069
Mailing address
3208 CHURCHILL AVE, FLINT, MI 48506-3021
(810) 736-3954
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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