Individual
MICHAEL LEE LONGENECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-3380
(928) 669-3377
Mailing address
833 W MEADE LN, FLAGSTAFF, AZ 86001-1210
Taxonomy
Speciality
Code
Description
License number
State
2471S1302X
Sonography Radiologic Technologist
Primary
36777
—
Other
Enumeration date
01/24/2007
Last updated
07/08/2007
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