Individual
MICHAEL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
9330 ARDEN BND, SAN ANTONIO, TX 78250-2710
(210) 200-9864
Mailing address
9330 ARDEN BND, SAN ANTONIO, TX 78250-2710
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1036820
TX
Other
Enumeration date
04/14/2021
Last updated
05/06/2021
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