Individual
BRIAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 281-8203
Mailing address
5801 BREMO RD, RICHMOND, VA 23226-1907
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0136000334
DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
03/03/2023
Last updated
03/03/2023
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