Individual
JESSE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2360 MULLAN RD STE C, MISSOULA, MT 59808-1811
(406) 542-4702
Mailing address
1305 E BROADWAY ST APT 103C1, MISSOULA, MT 59802-4943
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-LIC-24306
MT
Other
Enumeration date
05/20/2022
Last updated
08/05/2022
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