Individual
MR. GAVIN H LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
8534 W MILL RD, MILWAUKEE, WI 53225-1934
(414) 358-2090
Mailing address
6735 W BRADLEY RD, MILWAUKEE, WI 53223
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WI
Other
Enumeration date
09/29/2017
Last updated
03/17/2018
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