Individual
DR. WILLIAM FREDERICK LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
11 CHARLESTOWNE PLAZA, ST CHARLES, MO 63303
(636) 441-5585
(636) 441-5910
Mailing address
8001 NATURAL BRIGDE RD, MARIALLAC HALL, ST LOUIS, MO 63121
(314) 516-5987
(314) 516-5507
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02270
MO
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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