Individual
MR. MICHAEL KEITH LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN,BSN
Contact information
Practice address
606 N KANAWHA ST, BECKLEY, WV 25801-3819
(304) 860-2513
Mailing address
606 N KANAWHA ST, BECKLEY, WV 25801-3819
(304) 860-2513
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
75456
WV
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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