Individual
VICKIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, SUITE 240, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
1195 NUMIDIA DR, CATAWISSA, PA 17820-8629
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
9980690
PA
Other
Enumeration date
02/13/2009
Last updated
02/13/2009
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