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Individual

MR. ROBERT HENRY LONG SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2200 STANTON AVE APT C36, DES MOINES, IA 50321-2343
(515) 360-1377
Mailing address
2200 STANTON AVE APT C36, DES MOINES, IA 50321-2343
(515) 360-1377

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
824YY1420
IA

Other

Enumeration date
09/15/2023
Last updated
09/15/2023
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