Individual
KERRY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 1ST ST STE 505, JACKSON, MI 49203-3034
(517) 227-3700
(888) 323-2176
Mailing address
1203 1ST ST STE 505, JACKSON, MI 49203-3034
(517) 227-3700
(888) 323-2176
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
174400000X
Specialist
Primary
—
—
225800000X
Recreation Therapist
—
—
Other
Enumeration date
10/12/2022
Last updated
11/15/2022
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