Individual
KELLY A LONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6355 WALKER LN, SUITE 404, ALEXANDRIA, VA 22310-3245
(703) 797-6900
(703) 797-6905
Mailing address
9900 MAIN ST, SUITE 200A, FAIRFAX, VA 22031-3907
(703) 279-4394
(703) 279-4214
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204524
VA
Other
Enumeration date
02/07/2006
Last updated
07/08/2007
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