Individual
MR. WILLIAM J LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
1203 MECHEM DR, RUIDOSO, NM 88345-7210
(575) 258-2456
Mailing address
1203 MECHEM DR, RUIDOSO, NM 88345-7210
(575) 258-2456
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00003216
NM
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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