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Individual

MELISSA LOREN LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3624 J DEWEY GRAY CIR STE 308, AUGUSTA, GA 30909-6580
(904) 400-5056
Mailing address
3624 J DEWEY GRAY CIR STE 308, AUGUSTA, GA 30909-6580
(706) 922-7670

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10076
GA

Other

Enumeration date
12/21/2020
Last updated
01/28/2022
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