Individual
JENNA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
400 N 7TH ST, MARIETTA, OH 45750-2024
(740) 373-3597
(740) 373-3915
Mailing address
2420 LAUREL RIDGE RD, LOWELL, OH 45744-7435
(740) 350-4340
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
007307
OH
Other
Enumeration date
11/20/2013
Last updated
11/20/2013
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