Individual
LAURA M LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 W MAIN ST, HARTFORD, MI 49057-1008
(269) 621-3654
(269) 621-3534
Mailing address
302 W MAIN ST, HARTFORD, MI 49057-1008
(269) 621-3654
(269) 621-3534
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303007454
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5303007454
PHARMACY TECHNICIAN LICENSE
MI
Enumeration date
06/07/2021
Last updated
06/07/2021
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