Individual
KRISTOPHER LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11406 PEDIGREE LN, CHARLOTTE, NC 28269-1594
(704) 724-4988
Mailing address
11406 PEDIGREE LN, CHARLOTTE, NC 28269-1594
(704) 724-4988
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
NC
172A00000X
Driver
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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