Individual
WANITA L LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 MOUNT ALLEN DR, MECHANICSBURG, PA 17055-6171
(717) 697-4666
Mailing address
481 GARRISTON RD, YORK HAVEN, PA 17370-9519
(717) 418-2359
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE1002876
PA
Other
Enumeration date
12/22/2017
Last updated
12/22/2017
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