Individual
RAYSHELL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1461 OSPREY RIDGE DR, EUSTIS, FL 32736-2509
(352) 809-0442
Mailing address
1461 OSPREY RIDGE DR, EUSTIS, FL 32736-2509
(352) 809-0442
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
932434764
FL
172A00000X
Driver
Primary
932434764
FL
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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