Individual
MR. JUSTIN WAYNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
2085 HAMILTON CREEK PKWY, SUITE 160, DACULA, GA 30019
(770) 271-1488
(770) 271-1822
Mailing address
1013 SABLE CROSSING, SUWANEE, GA 30024
(417) 234-9856
(770) 271-1822
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008689
GA
Other
Enumeration date
09/11/2006
Last updated
07/08/2007
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