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Individual

MRS. JOANNE T LONGBONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
36100 EUCLID AVENUE, SUITE 170, WILLOUGHBY, OH 44094
(440) 602-6737
(440) 942-0316
Mailing address
7590 AUBURN ROAD, SUITE 014, ATTN: MED STAFF SERVICES, CONCORD TWP, OH 44077-9176
(440) 354-1899
(440) 354-1845

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.000470
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00829222
RAILROAD MEDICARE
OH
Enumeration date
04/25/2007
Last updated
08/06/2021
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