Individual
KIA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1443 WEST AVE UNIT A, HIGH POINT, NC 27260-4179
(336) 888-9754
Mailing address
1443 WEST AVE UNIT A, HIGH POINT, NC 27260-4179
(336) 888-9754
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
544302
NC
Other
Enumeration date
07/02/2019
Last updated
12/10/2020
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