Individual
MATTHEW M LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
7050 AIR DEPOT BLVD BLDG 1094, TINKER AFB, OK 73145-8716
(405) 736-2169
Mailing address
2301 NW 27TH ST, OKLAHOMA CITY, OK 73107-2517
(918) 845-7968
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2548
OK
Other
Enumeration date
05/24/2021
Last updated
10/08/2024
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