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Individual

HEIDI K LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
746 FAIRMONT RD, MORGANTOWN, WV 26501-4060
(304) 225-5222
(304) 225-5224
Mailing address
746 FAIRMONT ROAD, MORGANTOWN, WV 26501-4060
(304) 225-5222

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11880792
CAQH
WV
05
3810012350
WV
Enumeration date
06/09/2008
Last updated
03/26/2009
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