Individual
BROOKE LYNNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
PO BOX 21, SOMERSET CENTER, MI 49282-0021
(225) 361-6691
Mailing address
PO BOX 21, SOMERSET CENTER, MI 49282-0021
(225) 361-6691
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
103961
IN
Other
Enumeration date
09/09/2024
Last updated
10/22/2024
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