Individual
DANIEL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
233 MOORLAND WAY, LAWRENCEVILLE, GA 30043
(334) 703-6242
Mailing address
233 MOORLAND WAY, LAWRENCEVILLE, GA 30043-7574
(334) 703-6242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AT001724
GA
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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